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TUBERCULOSIS 

OR 

CONSUMPTION. 



— BY — 

H. H. SPIERS, M. D., 

RAVENNA OHIO. 



3 J J 3 J J 1 

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THE LIBRARY OF 
1 CONGRESS, 


Two Copiee Received 


JUL 17 1903 


l Copyright Entry 


CLASS ^ XXe. No, 

b 5 "I b 

COPY B. 



FOURTH EDITION. 
COPYRIGHT 1902 AND 1903, 

BY 

HENRY H. SPIERS, M. D. 

RAVENNA, OHIO. 



• • e e • 



• •• .e • 



To 

A Weak, Common 

and 

Suffering Humanity 

These Articles 

are 

Respectfully Dedicated, 



PREFACE TO FIRST EDITION. 



In offering these papers for a second reading, it is the 
hope they will diffuse, a brighter light by a collective ren- 
dering. Short articles, given from time to time, on various 
topics, and in many journals, seldom come under the eye 
of one individual. Hence the necessity of unity in presen- 
tation. The intractable nature of tuberculosis is our only 

apology. 

Respectfully, 

H. H. SPIERS, M. D. 
Ravenna, Ohio. 



PREFACE TO FOURTH EDITION. 



Fifteen years ago the law of tuberculosis was given 
the Portage County Medical Society, at Ravenna, Ohio. In 
December, 1890, it was presented to the profession at large 
through the Cleveland Medical Gazette. During this pe- 
riod of thirteen or fifteen years, the writer has constantly 
been before the medical public, upwards of one hundred 
and twenty articles have issued from his pen, in current 
medical literature. To-day, as never before, the causation 
and prevention of tuberculosis is clearly recognized. 

In this fourth edition of tuberculosis the writer en- 
deavors to present more clearly the manifest workings of 
law. In this attempt the generous patronage of an un- 
biased profession is asked. 

H. H. SPIERS, M. D. 

Oberlin, Ohio, July 1, 1903. 



PRELIMINARY STATEMENT. 



As my view of the origin of tuberculosis is at variance 
with established teaching, perhaps a simple statement of be- 
lief is necessary. 

1. Tuberculosis is a constitutional disease, dependent 
largely on the evils of civilization, and governed by the fol- 
lowing law : The death rate from tuberculosis is in direct 
ratio to suspension of atmospheric influence. 

2. The suspension or abeyance of atmospheric influ- 
ence may take place from within or from without. From 
without through impure or impoverished atmosphere ; from 
within through defective lung tissue, original or acquired. 

3. Abeyance of atmospheric influence, in whatever 
way induced, causes a depraved tissue or dyscrasia, through 
which the tubercle bacilli enter and grow. 

4. The growth of tubercle bacilli, being dependent on 
the precedent state or condition of the individual, is never 
per se the primary causes of tuberculosis. 

5. Tuberculosis may exist, though infrequent, in the 
absence of tubercle bacilli, but can never exist without the 
precedent state or condition. 

6. The plant growth, being a secondary condition or 
modifying influence in this most fatal disease, treatment di- 
rected against this growth must ever remain barren of per- 
manent curative results and dangerous to the patient. 

7. The precedent or primary condition being subject 
to law, and under control, tuberculosis is under control. 



—11- 



MECICAL THEORIES. 



When a small boy there came to my hands a pamphlet 
which stated the earth is flat, like a table, and rests on four 
huge elephants ; each elephant stands on four tortoise. 

Child-like I ask mother, what do the tortoise stand on? 

To me the theory was highly significant, but to be com- 
plete it required a little earth filling. 

Many theories of the past have been shown to rest on 
equally unstable bases. Many theories of the present, I 
apprehend, will be shown equally illusory. 

Many questions will be asked in the same child-like 
simplicity, and many learned disquisitions will be given to 
prove that which never did exist. Such is life, and such is 
the history of all human progress, with its periods of per- 
tinacity and vacillation alternately shown. Would you then 
discard all theory? By no means. Theory answers a great 
purpose in the world's advancement on scientific lines. 

Our theories are in one sense our ideals. We search 
for and endeavor to establish that which we really believe 
to be true. Thus far, theory is laudatory. But it is evi- 
dent a theory must be based on some thing more than pure 
imagination. 

Is the earth flat like a table, etc. ? Would it not be bet- 
ter to take established truth as a ground-work, and build 
on this? 

But where can established truth be found? 

In medicine, in theology and in law we .are constantly 
in search of it. 

Oft-times truth lies close beside us and we see it not. 

To-day the great medical telescope is located in Ger- 
many. Multitudes of people flock to hear its revelations. 



—12— 

Nothing worthy of credence, observation or regard is seen 
except through this instrument. 

To-day it is a bacillus — To-morrow a coccus. 

Each day is prolific in new schemes of detecting, cap- 
turing and destroying microbes. A very laudable under- 
taking to say the least. 

One microbe is accused, tried and condemned and the 
sentence is pronounced. Another passes through the same 
ordeal and comes out innocent. 

In the fatherland, a microbic court-of-law is in session 
at all seasons of the year. The strangely curious thing is : 
That whether innocent or guilty it matters not. No mi- 
crobes have received capital punishment in situ. 

In other words, no remedies have been found that will 
eliminate or destroy the microbe without causing the death 
of the patient. Let us look further. 

The savant Koch has demonstrated that in tuberculosis 
there is generally found a microbe at the seat of lesion. 
This is called the bacillus tuberculosis, for it is found in no 
other disease. That the microbe is present is universally 
acknowledged. They have been seen in colonies, in di- 
seased tissue, by innumerable observers. Seeing is believ- 
ing. Thanks to our distinguished contemporary. That 
this bacillus is the cause of the disease named has been re- 
ceived without serious question. 

The only serious question has been how to rid the sys- 
tem of the microbe. 

The result of treatment has been already shown. 

That the disease may be modified by the presence of 
the bacillus, I think there can be no serious doubt. 

That the microbe has any casual action in producing 
the disease is, in my judgment, pure speculation. 

Astronomers tell us that presumably the planet Mars is 
inhabited. 

If inhabited, who can say its people are not well up in 
the arts and sciences — possibly have telescopes. 

Imagine a resident of Mars engaged in the study of as- 
tronomy. Through his telescope he views the surface of 



—13— 

the earth and sees a flock of crows hovering near the car- 
cass of a sheep. What are these crows doing? Day by 
day he watches them closely. They are eating the sheep. 
At once he concludes that the sheep are being killed by the 
crows. A book is written. This is standard authority in 
Mars. 

But one observer sees a dead sheep on which there are 
no crows. Again he looks and descries another. He pub- 
lishes his observations and asserts that sheep die from other 
causes than crows. Is not the conclusion a valid one ? 

Again and again observers have found bacilli in the 
sputum and lung tissue of phthisis pulmonalis. Observa- 
tions to this effect have been published from time to time. 
The microbe is charged with causing the disease. This is 
standard authority. But one observer finds a case of 
phthisis pulmonalis in which no bacilli can be found in the 
sputum or lung tissue. He publishes the results of his ob- 
servations and I assert that people die of phthisis pulmona- 
lis, in which the bacilli do not enter as a factor. 

Is not the conclusion a valid one? 

A new observatory is now erected on the planet Mars. 
Its telescope is of the finest make and highest power. The 
observer brings his instrument to bear on the planet earth, 
and sees not only dead sheep and live crows in abundance, 
but also multitudes of little birds which he calls sparrows. 
He watches these little birds closely. They are engaged in 
a contest with the crows. They fight fiercely. At length 
the sparrows are victorious and the crows are driven from 
the field. 

The astronomer concludes his writings by saying that 
in order to prevent the death of sheep on the earth it is only 
necessary to increase the number of sparrows. A few tim- 
idly object to this teaching, but it is standard authority in 
Mars. Sparrows are now plentiful, but sheep still die. 
Something wrong. 

A new scheme is now devised to clear the earth of its 
dread visitant, phthisis pulmonalis. It has the sanction of 
high medical authority. Phthisis pulmonalis is caused by 



—14— 

tubercle bacilli. Two methods are open to rid the system of 
these microbes; the direct and the indirect, analogous to 
our dealings with the Indians in the past. Direct, to kill 
him; indirect, to take him from his feeding ground. In 
either event the microbe or Indian must die. A few timidly 
object, but this is standard authority. Tuberculin is plenti- 
ful, but mankind still die of phthisis. Something wrong. 

Science, though slow, makes progress even in Mars. 
A painstaking observer has been watching a sheep for many 
months. He has seen the animal die. Crows could not 
have killed him, for none are in that neighborhood. A 
brother astronomer examines the sheep and says he finds 
foot-prints in the earth near by — probably crow tracks. 
The crows killed the sheep, but were driven away by the 
sparrows, or fled from some other cause. Science in Mars. 

Likewise in earth science is progressive. A painstak- 
ing observer has been watching a case of phthisis pulmon- 
alis for many months. No bacilli are found in the sputa, 
though many examinations for the same have been made. 
The patient dies. No bacilli are found in the lung tissue. 
A brother scientist examines the body and finds tubercular 
nodules in the lungs. The bacilli caused the patient's 
death, but were either driven away or fled from some other 
cause. Science in the earth. 

The second observer in Mars reasons thus : Sheep die 
from various causes. Crows alone do not kill sheep. 
Crows simply eat the flesh of sheep after they are dead. It 
is the conditioji of the sheep that allows the crows to begin 
eating . 

The second observer in the earth reasons thus : Man- 
kind die from various causes. Tubercle bacilli alone do 
not kill mankind. Tubercle bacilli simply enter the tissue 
as a feeding ground. // is the condition of the system that 
allows the bacilli to enter. 



—15— 
LAW IN TUBERCULOSIS. 



In mathematics, whenever a regularity can be traced, 
the general proposition expressing that regularity is called 
a law. For many years I have been led to believe that 
tuberculosis is obeying certain fixed law, as planets obey 
law in revolving around a central sun. To the general ob- 
server this statement may seem chimerical. 

Zone. Ventilation. Death Rate. Ratio. 

Frigid Perfect Zero 1 

Torrid 5.. Less perfect 5 Small 1 

Temperate . 10 . , Least perfect 10 Great 1 

The ratio between ventilation and death rate is always 
constant. 

Tuberculosis obeying law? Apparently no order in 
appearance or disappearance. No regularity in mode or 
extent of visitation. ' Coming and going like the wind, or a 
bird of the air — all is chaos, discord and confusion. So 
thought the ancients of the worlds about us. But soon law 
is discovered ; order is evolved ; a system is formed and it is 
found that not only do the planets move, but in regular 
orbits and with matchless precision. Stand by the seaside 
and watch the incoming and outgoing tide. Note with ac- 
curacy the flood and ebb of waters. Without previous 
knowledge you could assuredly say these waters move in 
obedience to law. A law now fairly well understood — the 
law of gravitation. 

Stand by the bedside and observe the death rate from 
tuberculosis. Note the accuracy the figures tally year by 
year : Frigid zone, o ; Torrid zone, small ; Temperate zone, 
great. Without previous knowledge you could assuredly 
say these factors are essentials to the formation of law. 
On these essentials is based the law of tuberculosis. Ex- 
tend your observations to the coast line of a continent. 
Mark the varied difference in tidal wave in the various lati- 
tudes. Truly, you could say this law is not equally potent 
at all places — but observe it is, nevertheless, the same law, 
and the difference in height of tidal wave is due to the coast 



—16- 
line of the continent. Extend your research to prevalence 
of tuberculosis in the cities of the world. Mark the varied 
difference in places of the same latitude. Truly, you could 
say here is absence of law. But observe the same law pre- 
vails, and the difference of prevalence is due to abeyance 
of atmospheric influence. 

I herewith give, from standard authors, the maximum 
of tide for the places named: 

Bay of Fundy 75 ft. 

Boston .10 ft. 

Straits of Magellan 50 ft. 

Florida Reefs 2 ft. 

Head of Persian Gulf 36 ft. 

Mid-ocean 2 to 3 ft. 

I herewith append, from W. Halle, a partial table 

showing the prevalence of tuberculosis per ten thousand, 

1889 to 1890, for cities named : 

Brunn 76.7 

Baltimore 24.9 

St. Petersburg 48.8 

London 18.4 

Vienna 54.4 

Rome 22.5 

As the difference in height of tide along the sea coast 
does not invalidate the law of gravitation, neither does the 
difference in per cent of tuberculosis in the various cities 
invalidate the law of tuberculosis. 

In truth, the law in both cases is verified by the appar- 
ent contradiction. 

In dealing with the problem of the tides we find it 
complex and difficult. Equally complex and difficult is the 
problem of tuberculosis. If the tide and tuberculosis be 
alike based on law, they should alike be susceptible of dem- 
onstration, and barring preconceived opinions, should alike 
be worthy of credence. 

As already stated, the death rate is modified by abey- 
ance of atmospheric influence. The stabled cow, the 
penned sheep, the tame rabbit, the caged monkey, lion, 
tiger or elephant almost invariably die of tuberculosis. Sel- 



—17— 

dom, or never, do these animals die of this disease if living 
in the open air. The disease prevails much more among 
those whose vocations are sedentary than among those 
whose occupations are out of doors. The mortality in 
prisons has been shown to be four times as great as out- 
side. The death rate from phthisis is estimated at fifteen 
per cent of the total mortality, while in prisons it is from 
forty to fifty per cent. 

Primary tubercular lesions are, in a majority of cases, 
connected with the respiratory organs. 

"There is nothing essentially destructive or necessarily 
fatal in tuberculosis. That in all stages it may be checked 
and enable the person affected to live many years, and die 
subsequently of old age or other disorders." 

The Rev. Josiah Strong, author of "Our Country," 
said in my presence, a number of years ago, words like 
these : "When a young man I was declared consumptive. 
Sentence of death was pronounced by able physicians, east 
and west. I took no medicine; ate plain food and lived 
wholly in the open air. To-day I am the picture of health." 

Dr. Joseph Parish, of Philadelphia, gives a similar ex- 
perience. 

Many, no doubt, can recall cases that have a like bear- 
ing. It is, therefore, seen a constant ratio exists between 
ventilation and death rate. As the ventilation becomes poor 
the death rate increases and vice versa. The law then, as 
laid down in October, 1890, is simplified thus : The ratio 
between ventilation and death rate is always constant. In 
order to present this more clearly to the intellect, through 
the eye, I have arranged the following table: 

Zone. Ventilation. Death Rate. Ratio. 

Frigid Perfect Zero 1 

Torrid 5 . . . Less perfect 5 Small 1 

Temperate. 10. .Least perfect 10 Great 1 

If, then, a regularity be traced, what shall we say of 
law? According to the definition, law must exist. 

But it has been said that confinement, with insufficient 
ventilation means the presence of the bacillus. Observe 



— l&r- 

this. Exposure to atmosphere breathed by consumptives 
is not attended with danger so long as good ventilation is 
maintained. Observe this : 111 ventilation, whether in the 
private room or crowded tenement, invariably increases the 
death rate. Good ventilation, then, insures immunity. Ill 
ventilation insures death. Can this much be said of the 
absence or presence of the bacillus ? Is tuberculosis caused 
by the bacillus? Before the world today it stands not proven 
Look upon that field, with its depression in the center. 
The rains of heaven fall upon that field. The depression is 
filled with water and it becomes a shallow lake. Rushes, 
reeds and grasses, peculiar to low places, begin to grow in 
that lake. Did the rushes, reeds and grasses cause the 
depression? Did the rushes, reeds and grasses cause the 
lake? Drain the lake, the rushes, reeds and grasses dis- 
appear. But, says the objector, can we not take these 
rushes, reeds and grasses and make them grow on the arid 
mountains? Yes, we can; but how great the labor and 
how small the result. 

Yes, we can ; but nature does not work that 7vay. 
Look upon that man as he walks the streets. A bad 
family history, a prolonged illness — the depression in that 
field. Grinding poverty or pampered luxury has been his 
lot — the rains of heaven. Bacilli begin to grow in his 
lungs, are found in his sputum — the rushes, reeds and 
grasses. Did bacilli cause that man's history or illness? 
Did bacilli cause poverty or luxury? Take away the con- 
ditions, the bacilli disappear. But, says the objector, can 
we not inject bacilli, or a pure culture, into the healthy 
tissue and cause the disease? Yes, we can; but how great 
the labor and how small the result. 

Yes, we can ; but nature does not work that way. 
Tuberculosis caused by the bacillus? Tuberculosis is 
transgression of natural law. Violation of law brings its 
penalty; observation of law its reward. Standing near a 
spot sacred to every true American, I declare tuberculosis 
can be controlled. Not by the injection of chemicals— not 
by the injection of tuberculin. but by the observation of law. 



-19— 



MARRIAGE. 



Should an attempt be made to analyze the cause of 
marriage one would inquire into the nature of the desire 
implanted in the human breast. No attempt is made other 
than to express a judgment that it is largely social. In the 
beginning it was said : "It is not good that man should be 
alone." In this later day one portion of scripture seems to 
be tacitly acknowledged. 

Whatever the incentive that leads to marriage, whether 
love, impulse or ambition, in the eyes of the law united 
they are. The incentive per se may be of little import, 
but the union is the weal or woe of two lives and succeed- 
ing generations. Generally speaking, the incentive is of 
great import. 

Two of opposite sex meet in a car or at a party and are 
enraptured one with the other — a mutual liking. In what 
it consists even the participants can not explain, but it 
leads to marriage. 

One party sees another to whom he or she is attracted 
with an unwonted impulse. Every opportunity is sought 
for an introduction. The acquaintance leads to a wooing, 
which ends sometimes in an unrequitted love, but more 
often in marriage. 

Another desires to rise in the social or financial scale — 
a very laudable ambition. Who does not, if honestly at- 
tained? The hand and heart are sought wholly for this 
purpose, under the guise of a fervent love — and ends in 
marriage. 

There are also those of a sordid nature whose whole 
being is wrought up with having a good time. Matrimony 
has joys untasted. To these joys they are allured and seek 
kindred natures in marriage. 

Some seek wedlock as an oasis in the desert of life. 



—20— 

It is a constant theme of conversation ; little else is thought 
of. Any one of the opposite sex is accepted readily. 
These subjects marry early in life. 

Some look on wedlock as a snare into which the un- 
wary are entrapped. The subject is frequently referred to, 
but discernment is necessary in selection. These parties 
are hypercritical, and marry late in life, if at all. 

Again, we have the intellectual devotee, whose ques- 
tions, imaginary and otherwise, would deny the most ar- 
dent of lovers — who, in truth, settle marital questions as 
do the majority of people. 

Then there is the philosopher, who looks on wit, beau- 
ty and wealth as the mere accident or incident of fortune — 
the externals of life. Theoretically, these people have no 
choice except in health and a moral nature. Practically, 
the number who thus marry is very small. 

On examination, it is seen that in marriage, as in other 
things, all have a motive. Whatever the motive, the result 
attained is the home, the foundation and true secret of all 
organized society. On the purity of the motive hinges the 
secret of connubial happiness. Let those who contemplate 
wedlock and desire happiness study carefully this phase of 
the question. It will amply repay them. 

But marriage is something more than the union of two 
parties for life ; it is the offspring — it is to give to that off- 
spring a vigorous life. 

Many a man or woman is deterred from marriage from 
fearing its burdens and responsibilities, largely how shall 
we feed, clothe and educate those granted us ; but how few 
ask the greater question, how shall we best transmit health 
and long life to our children ? A vigorous constitution — a 
fortune in itself — readily secures the great objects of life. 
Physical weakness, however great the fortune, is doomed 
to doubtful victory or defeat. 

How much wiser the parent who transmits health than 
wealth ! How much wiser the state that frames laws to se- 
cure healthy citizens than the one which legislates to amass 
individual wealth ! How little regarded by legislators ! 



—21— 

Marriage is union — the joining of two segments, each 
incomplete in itself. Children are the fruit of this union. 

It is as consonant with reason to say that parents beget 
children after their kind as trees yield fruit after their kind. 
Observation shows it equally true. Still further, not only 
are the mental and physical excellencies or defects trans- 
mitted, but also the virtues or vices are transmitted in ex- 
cellence or defect. Let us endeavor to illustrate transmit- 
ted defect by a few familiar examples. 

A married couple start in life with good health as a 
fortune. By arduous toil a small tract of land is bought 
and a house erected. Another small tract is added. Still 
another, and so on, until five or six hundred acres are 
bought and paid for. Their life has been alone. No Sab- 
bath, no company, no holiday, no rest — continual toil early 
and late. I said alone — not so. Eight children have been 
added to that family. All are in poor health. The par- 
ents have been so engrossed in securing a competence as 
to forget a law of their being. 

Work — so commendable in all — carried to an extreme 
proves a vice. This vice is transmitted in physical weak- 
ness. The children must ever suffer the sin of their par- 
ents. We see this law illustrated in the wage-earner's fam- 
ily. Arduous toil, long hours, low wages, high rent, 
meager diet, etc., are some of the ways in which labor is 
degraded and physical vigor in parent and child emascu- 
lated. Legislation in behalf of those thus down-trodden is 
demanded. It would be beneficial to the human race. 

Not alone in this regard is manual labor. Intellectual 
work is subject to the same law and grievance. Many a 
brain worker in the race of life has fallen by the wayside, 
or in an attempt to live or secure a competence has trans- 
mitted feebleness to his offspring. One instance of intel- 
lect and application is recalled, who buried twelve children 
under two years of age. 

This law is illustrated in the drink habit of to-day. 
How often we see the imbecile, the idiot and the deformed 
in the family of the confirmed drunkard ! Who can say 



—22— 

these children are not equally deformed in their moral na- 
ture? They certainly are. How readily we condone an 
obliquity in a child when we know the weakness of the par- 
ents. In these and kindred cases law can accomplish much 
but I am satisfied education can do more. Not until man- 
kind clearly apprehend the law of their being will they be 
enabled to rise above a common level, even with the aid of 
human statute. How inefficient the best of statutes with- 
out an enlightened public sentiment ! Thus must it ever 
be, "line upon line and precept upon precept." Education 
precursory of true liberty. 

Dipsomania is not alone in its work of deterioration. 
It is but one in a series — though perhaps the greatest that 
is leading us down. Tobacco, opium, chloral, etc., have 
their votaries and claim their victims. Vicious habit is 
hydra-headed, and requires the actual cautery of education 
and law. Future generations demand it as their life. 

Rapid child-bearing is confirmatory of this law. In all 
great efforts of nature periods of rest are required. It is 
seen in the field and forest. In frequent births the mother's 
rest is short or nil, her vital force is reduced, and the chil- 
dren suffer from lack of nourishment intra and extra- 
uterine. This is seldom seen in the typical American home. 
More often is seen the pale face and wasted form of the 
mother striving to rear an only child in luxury that she may 
be a devotee of fashion. This much is open. Withdraw 
the curtain — too often is seen a bi-annual abort 'ion 

Among the privileged few is sometimes seen the family 
physician. To whom shall we attach the blame? To the 
frail mother? In the writer's judgment, nine-tenths of all 
abortions are procured at the instigation or request of the 
father. To whom the blame? To all concerned. Does 
such action affect a future offspring? Yes — mentally and 
physically — and that in a deleterious way. // is crime in 
the sight of God and man. 

Sickness in either parent causes feeble offspring. A 
father who begets children during a convalescence or ill- 
ness entails weakness in those children. A mother seri- 



—23— 



ously ill during gestation either aborts or the child shows 
an infirmity. Of course, there are exceptions, but the rule 
may be laid down as established, that no party should become 
a parent whose health is seriously impaired. 

Age in one or both parents modifies the offspring. 
The parents, not having reached maturity, it is often seen 
that the first or second child is feeble and subsequent chil- 
dren are strong. With the mother nature has her limita- 
tion. Not so with the father. In marriages where there 
is disparity of years, care should be exercised. How often 
we see the old man marry the young woman! Are the 
children vigorous? That depends. Some men are young 
at seventy, while others are old at forty. Age alone should 
be no bar to offspring. 

To recapitulate, vice transmits defect : 



Vice in 
Parents. 



Overwork, f 



mental or 
physical. 

\ Excess or 
vicious 
habit. 
Sickness. 

I Age. 



Choice. 



j To secure a 
< competence. 



To obtain 
Necessity, j a living. 
f Drink habit and others. 
J Rapid child bearing, 

abortion, etc. 
I 



i Feeble 
^Off- 
spring. 



The question may be asked, are the male and female 
equals in marriage ? In accountability to God and man, in 
the relations of life one to the other, they are equal part- 
ners. In the transmission of excellence, defect, similarity, 
etc., they may be equal partners, but at times there must be 
inequality. In the early months of pregnancy the child is 
subjected to maternal impressions. During gestation and 
nursing the fetus or infant is living on pabulum distinctly 
the mother's. One would naturally infer the disposition 
and dyscrasia of the child to be largely of the mother. Is 
the inference the observation? An intelligent mother 
says : "When eyiceinte I longingly desired to attend dances. 
My husband thought it not best and refused to go. My 
only child from his boyhood until now has a mania for 



—24— 

dancing." Another equally intelligent says: "I am ashamed 
of my daughter's actions, yet I am pleased she is trying to 
do better, for I know it is all my own fault. She acts just 
as I did in the early months of gestation." 

There is an inequality. At conception the father in- 
delibly stamps an impress, and the being passes from his 
control. His work is done. Not so the mother. In ges- 
tation the blood of the mother is the life of the child. So 
also in nursing. If the blood be impoverished the life of 
the little one is endangered. Abortion commonly occurs. 
The mother having a constitutional diathesis, the father 
being in health, the diathesis is more certainly transmitted. 
Reverse the conditions : the diathesis is less certainly trans- 
mitted. The mother then has a greater power of transmis- 
sion than the father. This can be clearly shown only in a 
limited number of diseases. Maternal heredity is stronger 
than paternal heredity in syphilis. The family tree in tu- 
berculosis inclines heavily toward the mother. The fetus in 
utero may be attacked with smallpox provided the mother 
is the subject of the disease. It is seen that while maternal 
impressions may affect all children it can only be presumed 
that maternal exceeds paternal heredity in all disease. Yet 
the presumption must ever be a strong one. 

Heredity is more or less a factor in gout, diabetes, 
mellitus and insipidus. The males having the disease are 
in preponderance to the females. This inequality does not 
show the male more readily transmits the diseases 'named, 
but that he is more subject to them. In fact, it rather 
shows the female the greater in transmission and the lesser 
in subjection. In that remarkable disease, hemophilia, this 
principle is still more strong. The mother transmits but 
does not inherit the tendency to hemorrhage, or, as a Dar- 
win might put it, the mother is a higher type of develop- 
ment. To formulate: 

1. The maternal impressions influence offspring. 

2. In all so-called constitutional or specific infectious 
diseases a transmission, if shown, is largely of the female. 



—25— 

From the above we would deduce : A race or stock is 
most surely improved by selection of mothers. 

I have dwelt somewhat at length on the incentive to 
marriage. Perhaps not wisely. In every community there 
are some who have great faith in human statute. If there 
be a beneficent change in any regard it must be by law. 
My view accords more to education. In a democracy, en- 
lightenment must precede statute. It is with this endeavor 
the apparently little incentive is shown. If one's inclination 
to a partner runs in a pretty face, amiability, wealth, etc., 
how absurd to so legislate as to restrict him to poverty in 
feature, disposition and fortune ! 

But if it be clearly shown that certain actions invaria- 
bly produce certain results; that a life of temperance and 
virtue is excellent and transmits excellence; that a life of 
debauchery and vice is defect and transmits defect, how 
clear it must appear to every well-thinking man and woman 
that there is but one way to ennoble and elevate mankind : 
To practice virtue and shun vice. Virtue is the observance 
of law, vice the violation of law — the law of our being. 
Let us shun vice and cling to virtue in marriage. 



—26— 



HEREDITY. 

John Milton, in "Paradise Lost," speaks of our first 
parents as "the loveliest pair that ever since in love's em- 
braces met." Milton is given to imagery, but who can 
think of a being more perfect than one fresh from the Crea- 
tor's hand, unsullied by environment, untarnished by sin? 
To me the creation should not only be lovely, but perfect in 
every particular. 

Looking back through the ages, I do not see Mother 
Eve with husky voice or disturbed respiration ; neither do 
I see Father Adam with bacilli or tubercular nodules in the 
lungs. To me the conception is a perfect creation — perfect 
in form and in health. 

We are told our parents fell from this estate. The 
exact nature of the sin will ever puzzle theologians, but this 
much is certain : Adam and Eve violated law. "Of man's 
first disobedience and the fruit of that forbidden tree whose 
mortal taste brought death into the world and all our woe 
with loss of Eden." 

Then, as now, violation of law brings its penalty, ob- 
servation of law its reward. 

Evidently, the Adam of to-day is not the Adam of 
creation. 

Had we a complete account of disease since creation — 
embracing not only literature but observation — I firmly be- 
lieve the record would show no tuberculosis in the early 
centuries. 

All animate creation living wholly in the open air are 
free from tuberculosis. Our ancestors were nomads — wan- 
dering from place to place in search of game or pasture, 
sleeping under nature's canopy — life akin to animate crea- 
tion. The disease, in the early centuries, must then have 
been unknown, for we have no evidence that nature's laws 
have in any way been modified or changed. 



—27— 

If, then, no tuberculosis lurked in the tissues of our 
first parents, if the disease did not exist in the early cen- 
turies, how does it appear that one-seventh of the present 
mortality is due to its inroads? A frank question, and it 
should receive a candid answer. 

Tracing the genealogy of the patriarchs from Adam to 
Noah, we find a longevity unparalleled in the history of 
mankind. During this period two things stand out in bold 
relief — outdoor life and length of days. These great object 
lessons may receive various interpretations. To me only 
one appears satisfactory: Outdoor life — a sequel to crea- 
tion ; longevity — a sequel of outdoor life. Interpret them 
as you may, length of days and outdoor life ever appear 
together. 

But it may be asked, is not immorality also associated? 
Yes, it is — a depravity of mankind, but not a depravity of 
the patriarchs. 

An exuberance of animal spirits — with lack of self-re- 
straint with the multitude — a consistent life of the few. 

We read of the general wickedness, of one hundred and 
twenty years given for repentance, of the flood, with the 
destruction of mankind. We also read "Enoch walked 
with God," "Noah was a just man and perfect in his gen- 
erations." 

A question now arises : Does heredity modify the av- 
erage life? In other words, does it make aught of differ- 
ence to your grandchildren or mine what our lives have 
been, so far as heredity is concerned? I verily believe it 
does ; that this has been true in all ages and in manifold 
ways. In primitive times the workings of a law on this line 
can be readily seen, but not as readily detected in the pres- 
ent generation. Methuselah, the oldest man of antedilu- 
vian days, was the son of Enoch, who walked with God. 
Shem, aside from his father the oldest man of postdiluvian 
days, was the son of Noah, the perfect man of God. 

If we carefully examine, I think history will show that 
not only do we inherit and transmit estates financial, but 



—28— 

intellectual, moral and physical as well. In Enoch and 
Noah we see illustrated a law of retribution. The children 
inherit, the parents transmit, a tendency to virtue, plus 
length of days. 

To formulate our view : A father shortens or extends 
his days by vice or virtue. He transmits to his progeny a 
tendency to vice or virtue, minus or plus length of days. 
The same may be said of the mother. One parent being 
vicious and one virtuous, gives parents and children an 
equal footing in the race of life. Both parents being vicious 
or virtuous, makes the law doubly sure. It follows as the 
world becomes virtuous, longevity is increased, and vice 
versa. Of course, we are speaking only of the law of 
heredity or physical descent. 

We hold, then, as in a vase, the treasures given us. 
We add or take from as virtue or vice governs us. We 
transmit — how often less than we receive ! 

By heredity is meant prenatal inheritance, that which 
one receives prior to birth. Tuberculosis is used in its 
most comprehensive sense. Heredity in tuberculosis, then, 
means prenatal inheritance of an intractable disease. 

In all ages heredity has been recognized. This child 
looks like his father, that child resembles her mother. 
Physical resemblance to the biographer is heredity to the 
biologist. 

Physical resemblance is not alone, a mentality is trans- 
mitted. How often we see a family of children with men- 
tal traits or characteristics of their parents ! Yet this does 
not always pertain. 

Perhaps no better illustration can be given than in the 
world-renowned Beecher family. Edward, the scholar; 
Harriet, the writer; Henry Ward, the orator — children of 
the eminent divine. A clear case of heredity in mentality. 
Yet to-day not one representative of that great family 
stands an equal in intellect to any of the four named. 

This brings us to a truth which I wish to indelibly im- 
press on the mind of every one. That while physical re- 
semblance and mental characteristic is transmitted, it is not 



—29— 

transmitted, so to speak, in one continuous stream, as with 
the river ; there are water-falls and rapids and meanderings 
so in heredity. 

Let no one claim that because heredity is not shown to 
be continuous it is no longer heredity. Heredity flows in 
no such perfect channel. On the principle of deviation in 
heredity and selection of offspring, Darwin has the great 
hold on the scientific mind. On this principle of deviation 
and selection the florist or stockman select the prettiest or 
best and make advances along this line. So in the thou- 
sand and one things we see around us. Ever since man's 
thoughts have been reduced to writing, perhaps before, 
certain diseases have been regarded transmissible from par- 
ent to child. Cancer, consumption and insanity belong to 
this class. 

Here is a field for the logician. If a healthy mentality 
be transmitted, why not a diseased mentality? If facial 
expression, why not other physical condition ? If tubercu- 
losis be a constitutional disease — and we believe it is — why 
not transmit the constitutional dyscrasia? 

Thus, to the logician arguing from probability, consti- 
tutional disease IS transmitted. Careful observation con- 
firms this probability. Insanity has been traced through 
successive generations in many families. Cancer sometimes 
shows itself in the offspring of the first generation, but 
more often in the second. 

Children of consumptives, though the environment be 
changed at birth , die of this disease among other healthy 
children, born of other parents. 

We have already shown heredity travels in no perfect 
channel. It is therefore seen that the proof of heredity is 
complete. 

But, say some, tuberculosis is not a constitutional dis- 
ease. It is a germ disease. The writer thinks differently, 
but for the sake of meeting on a common ground we as- 
sume you are right. 

The microscope makes many revelations. By its means 



—30— 

scrofulosis and tuberculosis are declared one and the same. 
This has been verified in Germany. We accept it. Scrofu- 
losis is modified by transmission, not so in tuberculosis. 
Thus it is seen, if the latter statement be true, the diseases 
which are declared one and the same are not one and the 
same. If one and the same they would alike be modified 
by heredity. 

Let me illustrate : My friend and I are walking in the 
country. .1 exclaim, "What a lovely white house !" "Yes," 
says my friend, "but that house is also black." You don't 
mean that same house is both black and white at one and 
the same time? That is just what I mean. Well, I fail 
to see it. My friend replies : "Were you ever in Germany ?" 
"No sir, I never crossed the North Atlantic." Well, that 
explains it. 

Ladies and gentlemen, are you satisfied with the expla- 
nation? Would it not be wiser to call things one and the 
same that agree in every particular ? 

If these diseases be one and the same, heredity in tub- 
erculosis is rendered stronger than probable. 

Let us take another step. For many years it was a 
moot question whether living bacilli could be transmitted. 
It is now universally agreed they may be carried by the cir- 
culation to various parts of the body and through the fetal 
circulation to the fetus itself. Ardent bacteriologists ex- 
claim: "Why look for heredity? Here are seeds of disease 
carried to the prenatal offspring." 

Please reflect one moment. Did it ever occur to you 
that before a plant can take root there must be a suitable 
soil or condition of growth? Which takes priority, the 
plant or the soil in which it grows? Answer that question 
honestly and you condemn yourself. 

The moment you admit a growing bacillus at birth, 
that moment you tacitly admit heredity in tuberculosis. 
Heredity in tuberculosis is all we claim. 

We must not stop here. Imagine 1 before you five ladies 
who gives instruction in painting on canvas. Your daughter 
wishes to acquire the art. Before selecting an instructor, 



—31— 

suppose you put a test question to each of these teachers. 
You hold a fabric in your hand and ask severally the color. 
Listen to the answers : Red, blue, orange, violet, indigo. 
What arises in your mind? One of two things — either 
these ladies are deceiving you, which is improbable, or else 
they do not understand the business they profess. What 
painter could instruct in blending three to five hundred 
shades of color who could not distinguish a primary one ? 

You have a son to send to college. You call before 
you five leading clinicians in the state and put to each the 
test question: What factor is heredity in tuberculosis? 
Listen to the answers : Nothing, little, much, a great deal, 
all. What arises in your mind ? One of two things — either 
these teachers are deceiving you, which is improbable, or 
else they do not understand the business they profess. 

Who can instruct except they who know f 

Ladies and gentlemen, have we been teaching error in 
the past? Come, let us acknowledge our fault, or rise in 
our place and refute what is said. 

We have not reached the pinnacle as yet. There is 
another step. With heredity in tuberculosis declared and 
demonstrated, an herculean work must be wrought. 

In marriage something more than minister or justice is 
required. It needs : 

1. General enlightenment in order to select. 

2. A physician's certificate by both parties prior to 
the marriage contract. 

3. A secretary of forensic medicine, with a universal 
marriage law. 

Ladies and gentlemen of the profession, when we rise 
to the occasion and demand these, they will be granted. 



—32— 



THE PRECEDENT STATE. 



When Robert Koch announced the discovery of the 
tubercle bacillus, its invariable association with tuberculosis 
and its consequent causative influence, the medical world 
were ready to accept anything as a working theory. Tuber- 
culosis had hitherto been an intractable disease. It was 
argued that when we have greater light or insight into the 
cause or causes of the disease, then we will be more suc- 
cessful in treatment. 

Some few physicians had anticipated the discover/. 
Others could see no reasonable objection to the conclusion. 
Figuratively speaking, the entire medical profession took 
off their hats and hurrahed. 

Had Koch discovered the same germ in health, deter- 
mined its invariable association and declared the presence 
of the germ the consequent cause of health, he perhaps 
would not have awakened the enthusiasm, but the truth 
uttered would have been equally clear. 

Tubercle bacilli are ubiquitous ; are found in both 
health and disease. Growing bacilli are found only in dis- 
ease. A soil must precede the growing plant. Hence, 
growing bacilli imply a precedent state. 

What causes the precedent state? The error of Koch 
is a common one. Birds are seen on the growing plants. 
They are the supposed cause of failure in certain crops. 
The birds are killed. It is then found the birds were eat- 
ing the enemies of the growing grain. Tubercle bacilli are 
looked upon as the enemies of human kind. The profession 
have been largely engaged in their destruction in toto. 
To the writer it seems, should the extermination prove suc- 
cessful, tuberculosis would still exist. 

One thing should be plain to every observer : Health 
and the tubercle bacillus do not constitute disease. Some- 



—Ba- 
thing more is required, viz., the precedent state. 

What is the precedent state ? It is the condition of the 
individual that allows or encourages the growth of tubercle 
bacilli in his system. The tubercle bacilli are present in 
the bodies of every animate creature. They may be in the 
saliva, the blood, the tissue, etc. 

If the person be in health, or in other words, if there 
be no precedent state, these germs remain, or come and go, 
and cause no systemic disturbance whatever. 

Should the person inherit or should he acquire the pre- 
cedent state the living tubercle bacilli at once take root and 
flourish, for the temperature of the body is favorable to 
their development and growth. When these germs are 
found growing in the human body the person is said to 
have tuberculosis. Should one receive or acquire the con- 
dition favorable to the growth of these germs, this person 
may be said to have the precedent state. 

What is the precedent state ? Incipient tuberculosis — 
tuberculosis in the absence of tubercle bacilli. As elsewhere 
stated, tuberculosis may exist, though infrequent, in the 
absence of tubercle bacilli, but can never exist without the 
precedent state. 

In how many ways is the precedent state commonly 
received? In two ways — heredity and abeyance of atmos- 
pheric influence. 

Please explain in what way one inherits the precedent 
state? The precedent state is most commonly inherited 
through a tuberculosis ancestry. The same state may also 
be inherited if one or both parents at conception, or the 
mother during gestation, be suffering from suspension of 
atmospheric influence, either from causes original or ac- 
quired. This, to some, may seem strange, but must of 
necessity be true. It is simply the violation of law on the 
part of the parents the precedent state transmitted to the 
children. 

To secure a healthy offspring it is shown to be just as 
necessary to live right as to marry right. A premium is 



—34— 

therefore placed upon correct living and the taking of 
proper persons in marriage. To render this plain, let me 
illustrate : A mother or father has tuberculosis at concep- 
tion. Perhaps it is both parents who are afflicted with the 
disease. The children born die of tuberculosis. This 
seems plain. 

In the above, instead of tuberculosis, place the prece- 
dent state. The sentence then reads : One or both parents 
have the precedent state at conception. What would one 
reasonably expect as to offspring? They would likewise 
have the precedent state. With children thus born, how 
easy to explain results. 

Many obscure cases are rendered clear by this explana- 
tion. We cite one by Austin Flint,. Sr. ("Practice of Med- 
icine," 1S73) : 

"Dr. Henry E. Paine, of Dixon, 111., illustrates a con- 
genital tendency without the evidence of inheritance. Mr. 
S. is fifty-seven years of age and in good health. His wife 
is fifty-two and well. No progenitors have been known to 
die of tuberculosis. All the children, five in number, died 
with this disease between 1853 and 1861 ; their ages respec- 
tively being at the time of death twenty-three, twenty-five, 
twenty-four, twenty-two and twenty-three." 

In the absence of knowledge as to the occupation, 
mode of living, previous history of disease, etc., of Mr. and 
Mrs. S., the writer has the right to assume : 

1. Mr. or Mrs. S., one or both, had pneumonia prior 
to marriage. In common parlance, they were well, but 
each had a bronchial difficulty, or perhaps an hepatized 
lung. To what does this condition tend ? Suspension of at- 
mospheric influence — the precedent state. 

2. Mr. or Airs. S.. perhaps both, were engaged in an 
unhealthy occupation. Mr. S. in a tow-mill or grinding on 
an emery wheel ten hours per day, constantly spitting black 
dust from his lungs. Mrs. S. making shirts in close quar- 
ters fourteen hours per day. In either case to what would 
this induce? Suspension of atmospheric influence — the 



—35— 

precedent state. 

3. Their manner of living was unsanitary. Mr. S. 
was a miser. He lived in one room and kept the door shut 
to save fuel. Mrs. S. was a crank and afraid of night air. 
She put. the children to bed and covered their mouths to 
keep out the cold or heat. To what would this condition 
of things tend ? Suspension of atmospheric influence — the 
precedent state. 

Under these circumstances the parents were well or in 
good health, but their progeny received the precedent state 
just as truly as though both parents were suffering from 
tuberculosis. Result — the children died of tuberculosis. 

The result would have been the same had the parents 
lived in our generation. They might have indulged in 
present scientific fads — the injection of tuberculine to cause 
sloughing of diseased tissue ; the placing of sterilized gauze 
over all apertures for ventilation to prevent the entrance of 
microbes, so fatal to children ; or, were they familiar with 
present ideas in the fatherland : the securing of artificial 
immunity. The writer believes that under anv or all of 
these so : called cures or preventives the children would have 
died as they did, of tuberculosis. 

It is not cure, but prevention, that will ultimately con- 
trol the disease — prevention, not by injection, but by con- 
trollijig the precedent state. 

But hold!!! Why not assume Mr. S. had a right in- 
guinal hernia or Mrs. S. scarletina in infancy? The reason 
is obvious. Nothing is assumed that does not naturally 
lead to the precedent state. 

Does it necessarily follow that one having the prece- 
dent state must die of tuberculosis ? It does not necessarily 
follow. It must be remembered the precedent state is the 
first link in a great chain If there be no first link the 
chain will never be formed. If the first link be present, 
others are readily added. In a typical case will other links 
be joined? That depends. For the individual it must ever 
be a constant battle. 



—36— 

Let us endeavor to make this clear. Mr. A. has the 
precedent state. The soil in his system is ready for the 
seed. The tubercle bacillus, the seed, is constantly present. 
What is the probability? The seed will at once! take root. 

How best to proceed? There are three methods : 

1. To get away from the germ. 

2. To get away with the germ. 

3. To leave the germ alone or rid one's self of the pre- 
cedent state. To use terms more consonant with science: 
(1) Germ exclusion; (2) germ destruction; (3) germ non- 
intervention. 

1. Dr. W. Van der Hayden, a bacteriologist of Japan, 
has recently built a microbe-proof house. Its manner of 
structure, dimensions, etc., are known to many. We will 
not refer to these. Japan is young in science. Science in 
theory and science in practice are two things. Suppose the 
germs cause the disease; the house perfectly excludes the 
germs. It is evident the doctor cannot always remain in 
his house. He must be a live M. D. He must attend 
to business. Will he take the house with him constantly? 
He has a field to cultivate. Will he kindly loan the house 
to his servants while at work ? He has a large manufactory 
in which thousands of hands are employed. Will he in- 
clude this establishment in his microbe-proof house? If 
not, why not? The doctor will find theoretical science is 
not practical. 

We now introduce another class. In this we have the 
intellect of our land. Says an authority : Whenever I see a 
case of incipient tuberculosis I exclaim : "Haste to the 
mountains." "Escape for thy life !" The writer asks why 
so great haste ? To get away from the germs. 

"Come, let us reason together." , Suppose you stand 
before two bare rocks, the one on the right hand, the other 
on the left. On the one rock is placed one kernel of wheat. 
On the other rock is placed one thousand kernels of wheat. 
The conditions of growth, light, heat, moisture, etc., being 
the same, which would germinate the sooner, the one kernel 



—37— 

or the one thousand kernels ? The writer asks any man in 
the land to show a difference in germination. Why do you 
hasten your patients to the mountains? To escape from 
the germs of disease. What is foolishness ! 

Do not germs exist in the mountains ? They are' not so 
plentiful in the mountains. Tf germs cause the disease, if 
the condition of the system be favorable to their growth, 
are not a few germs all that is necessary? 

Tf absence from germs be all that is required, please be 
consistent. Why not lease Dr. Hayden's microbe-proof 
house ? The truth lies here, the mountains do benefit, but 
the benefit does not consist in absence of germs. It con- 
sists in more perfect aeration of the blood. In other words 
the more perfect aeration drives away the precedent state 
and the germs do not grow. Let this be remembered. 

To recapitulate : (a) Science has no practical method 
of germ exclusion; (b) had science such method it would be 
useless unless germs cause disease. 

2. Germ destruction. It is true germs may be de- 
stroyed. There are germicides in abundance, and some of 
them very efficient ones. It is also true that science knows 
no method of total germ extinction. Had we such method 
it would be useless unless germs cause disease. The writer 
thinks the latter stands not proven in tuberculosis. 

3. Germ non-intervention. This is the author's own 
method, and, he thinks, has the merit of being practical. 



—38— 



WHOM TO MARRY. 



So long as medical men firmly believe the germ theory 
of tuberculosis, so long there will be no true progress in 
prevention and control of this disease. 

So soon as we grasp the idea of a precedent state or 
condition in the individual prior to the advent of the bacil- 
lus so soon we take the first step in prevention and control 

There can be no definite action until there is clear ap- 
prehension. 

If one only cares to look he can readily see the tubercle 
bacilli do not grow in the normal or healthy tissue. It is 
always in the abnormal or unhealthy tissue they take root 
and flourish. 

Tubercle bacilli, then, differ from the ordinary para- 
sites that infest the animal and vegetable kingdoms. 

Again, a recognition of heredity in tuberculosis — a per- 
ception that something is inherited other than an active 
bacillus — likewise leads to investigation that will enlighten 
and aid in controlling the disease. It is into a channel of 
this character we desire to enter at this time. 

We have elsewhere stated, "Abeyance of atmospheric 
influence, in whatever way induced, causes a depraved tis- 
sue or dyscrasia, through which the tubercle bacilli enter 
and grow." In other words, a law underlies the formation 
or creation of the precedent state or condition. 

In heredity the precedent state or condition of the off- 
spring is received direct by parental transmission at con- 
ception, or more slowly, through the mother during intra- 
uterine life. 

At conception the father's work is complete. If the 
father at this time have a constitutional dyscrasia, or if he 
be violating a law of his being so as to impair his organism, 
the fetus will certainlv show this dvscrasia or violation at 



—39— 

birth or in after years. The same may be said of the mother. 

If both parents have this dyscrasia or are violating law, 
the result named to the fetus is doubly certain, or, perhaps 
better, doubly strong. 

At conception the work of the mother is incomplete. 
During gestation, if the blood of the mother be impure or 
impoverished, it will certainly cause the death or deterio- 
rate the health of the intra-uterine offspring. This state- 
ment is confirmed by every-day observation. It is therefore 
seen that the character of the offspring must be largely de- 
termined by the health of the mother. 

If we are clearly understood, the precedent state or 
condition is found in two classes : 

1. Those who in any way, suspend atmospheric in- 
fluence. 

2. The fetus or intra-uterine offspring under the con- 
ditions named. 

Or perhaps it is rendered clearer by saying the preced- 
ent state or condition is received in two ways : 

1. Suspension of atmospheric influence. 

2. Heredity. * 

While the law of formation or creation of the precedent 
state or condition may be active in the ancestry, it is neces- 
sarily inactive in the prenatal offspring, per se ; hence a 
question now arises : 

How do you reconcile a condition induced by law and 
the same condition induced by heredity in which this law is 
held in abeyance ? 

An illustration perhaps will render this clear. Along 
the ocean coast there are tides. These tides are governed 
by law. A prevailing wind increases or diminishes the tide 
at any point of the ocean shore. Heredity is a prevailing 
wind. Heredity may increase or diminish the death rate 
from tuberculosis. 

Eliminate all disturbing elements and there would be 
uniformity in tide. Eliminate disturbing elements in tu- 
berculosis, of which heredity is one, and there is uniformity 
of action in law. There is this difference : The tide may 






—40— 

never be governed; heredity is, in many instances, con- 
trolled. 

Having tried to make plain the conjoint action of law 
and heredity in tuberculosis, showing that in some instances 
heredity aids the action of law and in others militates 
against its action, let us now proceed to discuss a topic in 
which we all are directly or indirectly interested, viz., mar- 
riage. 

A certain farmer writer has compared marriage to the 
garden of the farm — in many ways a beautiful and happy 
comparison. The garden, a mere patch, highly cultivated, 
yields the choicest and most luscious fruits ; marriage, a 
fraction of duration, happily consummated, yields an off- 
spring, the joy and jewel of our lives. The garden returns 
according to seed, soil and degree of cultivation ; marriage 
returns according to parents, mother and care in after 
years. 

Let there be no mistake. Nature is not mocked. As 
the seed, soil and cultivation, so the fruitage. 

In marriage so many questions are involved that it 
seems like complication to add other conditions to those 
already known. But if the future welfare of a people de- 
mand care in selection, it must be granted that no care is 
too great. 

From time immemorial the man has sought the woman. 
It is the man who "pops the question." The woman 
chooses in the negative — receives or rejects'. Whether this 
order should be changed, whether the change would be ben- 
eficial, are questions we will not discuss, but there is one 
thing on which the writer expresses himself, viz., every 
man or woman's family history should be a public record. 

As one in the purchase of real estate goes to the public 
record to examine the title, so every one should have the 
right to examine a record of heredity when selecting a 
partner for life. This may be deemed foolish, but it is a 
foolishness beneficial to mankind. 

Let me illustrate. You select a partner. Whether 



—41— 

guided by impulse or choice in the selection, she pleases you 
and the union is joyous but for one thing — in a number of 
years, more or less, usually less, the wife dies of tubercu- 
losis. Yet more — the children have a history of tubercu- 
losis. Perhaps this is the record of a husband. The result 
to him is just the same ; not always so to the children. 

All observers agree that tuberculosis travels most 
readily through the mother. Why? Because it is the 
mother who sustains the fetus during gestation. A di- 
seased condition of the mother if therefore more liable to 
be transmitted. 

Father and mother are equals in conception, unequals 
in gestation. 

As social custom gives man the province of selection, 
observation should teach him to select wisely. As social 
custom prescribes woman an acceptance or rejection, she 
should be taught to accept or reject wisely. 

WHOM TO MARRY. 

Let no man propose to a woman who has a clear fam- 
ily history of tuberculosis. Let no woman readily accept 
a man with a clear family history of tuberculosis. 

While the woman, under certain conditions, as voca- 
tion, environment, etc., may accept a husband with a hered- 
itary taint of tuberculosis, it is best for her not to do so. 
Under no circumstances should one secure a wife with a 
tubercular history. The progeny in the former case is 
generally free from the disease, but not always so; the 
progeny in the latter case are seldom or never free from 
the disease. Of course there are exceptions. 

Intermarriage of tuberculous subjects should be pre- 
vented by legal enactment. 

What more can we say? In prevention of tuberculosis 
education and restraint should be the watchword. In all 
theorizing, practical results should be the object or aim. 



-42- 



EDUCATION. 



We must educate. We must educate. This has been 
the watchword in our country since its early history. A 
commendable watchword. Washington, Franklin and 
others expressed the same in like words. 

Some restrict education to the acquirement of knowl- 
edge. It is more than this. Education has for its object 
the development of the powers of man. This development 
may be along many lines of work. It truly includes orig- 
inal work. People must be educated even to think. 

It does not follow, then, that he is best educated who 
has the most information in store ; the largest library. 
Rather he is best educated who best reasons from cause to 
effect • who, while having the requisite knowledge to in- 
quire, has also the ability to generalize. 

We speak thus particularly, for many think education 
and acquisition of knowledge are synonymous. There is a 
distinction and ofttimes this distinction makes the differ- 
ence in mankind. 

On no topic do we more clearly require education than 
on the one before us. Our mental shelves are laden with 
acquisitions, but in the writer's judgment little education is 
present. False notions and ideas have become so blended 
and intermingled with actual knowledge that much is 
taught which lies in shadow-land, that cannot endure the 
test of time. Education should lift us through or above 
the shadows into the reality; open the veil before us to let 
the sunshine of truth enter. We must educate, but we 
must do so as to awaken latent thought, cultivate original 
research, and teach every man to think independently. 
Then education will be of value. 

Today there is a germ theory of tuberculosis. Truly, 
it is a theory. Is it anything more ? We think not. Med- 



—43— 

ical works are filled with disquisitions on the tubercle bacil- 
lus, the so-called cause of tuberculosis ; when, where and 
how the germ is detected ; its significance when found or 
when not found; the procedure, if latent or growing; the 
way to capture, isolate and cultivate; the best microscope 
to look at, after or into the invader, etc., etc., etc. 

This is all very well so far as it goes, but it seems to 
the writer like superficial cultivation. We need occasion- 
ally a subsoiler that will strike deeper and bring up that 
below into the sunlight. 

A number of years ago an enthusiastic agent was intro- 
ducing a certain kind of honey bee. Among the many 
points of excellence of this particular bee was its size, hard- 
iness and qualities as a honey collector ; so large no other 
bee would quarrel with it ; so hardy the climate had no 
effect upon it ; so great a worker it did not require feeding. 
He dwelt on these points with a fervid oratory. A hive of 
peculiar construction was then introduced. It excelled 
every other in that the holes or exits were so small that no 
enemy of the bee tribe could enter. The hive was abso- 
lutely safe from all invaders. At this juncture an old 
farmer arose and asked how so large a bee could enter so 
small a hole. The agent was evidently master of the situa- 
tion and blandly remarked this was no business of his what- 
ever ; this is the bee's look-out. 

After so much talk on the tubercle bacillus, what it 
does and what it does not, the writer is somewhat in the 
position of the old farmer, and asks how the tubercle bacil- 
lus enters the healthy organism ? The reply is equally log- 
ical : "This is the look-out of the tubercle bacillus." 

This seems the only answer ever given by the bacter- 
iologist. Is there no other? We think there is. The 
fighting qualities of the tubercle bacillus, like the Span- 
iards, is vastly over-rated. Each desires little to do and 
plenty to eat. Neither would forcefully enter a harbor for 
temporary or permanent rest. How, then, do the tubercle 
bacilli gain a footing? By falling as a seed by the wayside 
and simply taking root ; by eating the first food that pre- 



—44— 

sents and satisfying a natural craving or hunger. The 
tubercle bacillus is not seeking whom it may devour. It 
never goes out foraging, but is everywhere present, and 
wherever there is suitable soil, simply grows. It is evi- 
dent that a soil must precede the growing organism. 
Every biologist will acknowledge the accuracy of this state- 
ment — first the soil, next the organism and lastly the 
growth. 

Say not, then, that the tubercle bacillus is a parasite. 
It is not a parasite. It is a vegetable organism, taking root 
in a fertile soil. The soil precedes, is prepared for and 
nourishes the growth of the organism. What is the mis- 
sion of the organism? That of a scavenger. It takes up 
the old, useless and worn-out tissue that has no further vir- 
tue in the economy. When this effete tissue is wholly 
taken up the organism disappears. So long as this tissue 
forms the organism thrives. 

In tuberculosis an animal debris is continually present. 
Suspension of atmospheric influence causes the debris or 
worn-out tissue. Remove the suspension and you at once 
remove the formative process. No formative process, no 
tuberculosis. This information may seem strange; may 
not be found in standard works ; yet is nevertheless true. 

The tubercle bacillus is not the cause of tuberculosis. 
There is another cause, viz., suspension of atmospheric in- 
fluence in whatever way induced. 

With this truth clearly before us and ever in mind, no 
fear need be entertained regarding the tubercle bacillus. It 
is perfectly innocent and may be so considered by all. We 
are living in troublous times. The outlook is brighter. 

Let us gird on our armor, fight the battle with courage 
and take heart for the future. 

A crisis is upon us. Men of science have laid out the 
metes and bounds of knowledge in this disease. "Thus far 
thou shalt go and no farther." Men of observation, per- 
haps equally wise, see no progress — rather decadence ; ob- 
serve a weakness or inefficiency in present methods. They 
boldly ask why this educative empty nothingness. Men of 



—45— 

the schools who hold place, perquisite and power ask why 
this cadence of invective. Each in his way maintains his 
right — a battle for supremacy. 

It becomes every thinking medical man to use his in- 
fluence for the right, whatever may betide. Disease stalks 
rampant through the land. Servitude, if of value, is hon- 
orable. Serfdom to a theory is dishonor. In this disease 
the gall and bitterness of bondage are severely felt. Are 
we thinking men? Let us feel the chafing of a foreign 
yoke no longer. 

What is tuberculosis? Says one: "An infective di- 
sease caused by a germ." Says another : "A systemic di- 
sease caused by violation of law." One says : "No tuber- 
culosis without a germ of disease." Another says: "No 
tuberculosis without violation of law." One holds a vege- 
table organism or plant growth as necessary. Another 
holds violation of law or ill-ventilation as necessary. No 
tubercle bacillus, no tuberculosis. No suspension of atmo- 
spheric influence, no tuberculosis. One tries to catch or 
antagonize a bacillus. Another tries to correct or modify 
present action of law. One could prevent disease if no tu- 
bercle bacillus. Another could prevent disease if no viola- 
tion of law. One says : "Give us more time ; it is a ques- 
tion of science." Another says : "Give us a hearing; it is 
a question of common sense." One stands entrenched 
with shield and banner displayed. Another stands in the 
open, fearing no defeat. What medicine can be more prac- 
tical than preventive medicine? 



46— 



FOOD PRODUCT. 



No factor is more conducive to the well being of a peo- 
ple than diet or food product. If we turn to history and 
seek those nations which have secured the most lasting re- 
gard or aggrandizement, we invariably find a people well 
fed. Per contra, should we seek the tribe or race lowest 
in the scale of existence, whose history — if so it may be 
called — lies in the unwritten legend or tradition, whose 
home is migratory and uncertain, we find an insufficient 
diet, with alternate plenty and privation. 

So true are these statements, that brawn and brain 
work most harmoniously and efficiently when food product 
is adequate to the animal economy ; so true are these state- 
ments that, other circumstances being equal, given the diet 
for five consecutive generations, the condition of a people 
may be fairly determined. 

No better illustration can be given than in the exam- 
ples of Great Britain and India. 

Great Britain, synonym for strength, has fought with 
nearly every nation of the earth, and to-day controls a do- 
main on which "the sun never sets." Great Britain, a land 
of liberal diet. 

India, synonym for weakness, vast in area, population, 
resources and willingness to pay taxes ; vast in little else, 
controlled by a few thousand alien soldiers. India, a land 
of restricted diet. 

Exchange the food product for five generations, think 
you their relative strength would remain the same? 

As with the nation, so with the individual, though less 
marked. Show me the man or woman whose whole life 
diet is scant or insufficient, and I will show you the intel- 
lectual or physical weakling. Bone, brain and muscle are 



—47— 

built on food ample in quality, quantity and variety. When 
little Oliver Twist calls for "more" it is no idle, childish 
whim or folly, but is an urgent call of wronged nature. 
The soup is too thin, the quantity too small, and the qual- 
ity deficient. Are there any little children in this land of 
plenty who are calling for more? Examine closely before 
you say no. 

Thus far we have spoken of normal or wholesome food 
product. But at times a staple production fails, or is de- 
fective or diseased through climatic or other causes. A 
people dependent on one production must then face starva- 
tion or become enervated through diet. The famine in Ire- 
land through failure of the potato crop, or local outbreaks 
of ergotism through eating black rye, etc., are familiar ex- 
amples. Again, a food product may be defective in that it 
is improperly cared for. Mouldy hay or musty grain must 
impair the health of the animal that eats them. Over-ripe 
fruits, partially decayed vegetables or meats improperly 
kept must cause sickness to the consumer. In regard to 
a food product there is only one royal way — to select only 
the best. 

Of food product there is only one with which we all are 
perfectly familiar ; only one that fulfills every indication, 
meets every want, and in truth is ideal — -pure milk. Per- 
fect and familiar food as milk is, no article has been more 
used and misused. To-day it stands eulogized and con- 
demned. One fact remains — pure milk a perfect food . 

The purity of milk is affected by intrinsic or extrinsic 
causes. In other words, milk may be changed during se- 
cretion or after it is withdrawn. Of the various changes 
that take place after milking we will not refer, but simply 
state that they all may be prevented for a longer or shorter 
period by proper sterilization. Various apparatus are on the 
market and perfection in this regard seems to be reached. 

While sterilization is thus regarded so favorably there 
is one thing it can not do, as will shortly appear. 

Of the various changes that take place at or during se 
cretion we wish to speak more particularly. 



1. It is asserted by high medical authority that tuber- 
culous animals secrete milk containing bacilli. So far as 
known, no one argues their presence in the milk. Seeing 
is believing. 

2. That by sterilization the bacilli may be killed and 
the resultant milk rendered a perfect food. 

In the judgment of the writer this statement is as near 
prevarication as is Bill Nye's description of a cyclone. It 
contains some truth, but most of it is mythical. That 
bacilli may be killed by sterilization or that there are cy- 
clones, no one denies. That tuberculous milk may be ren- 
dered perfect food by sterilization is as mythical as Nye's 
description. 

There are two things of which American physicians 
can justly feel proud — practical ideas and good common 
sense. Suppose during the famine in Ireland that the 
Americans, instead of sending a ship-load of corn, had sent 
a ship-load of sterilizers. Would the famine have been 
staid ? Suppose during an outbreak of ergotism some one 
should suggest sterilization. My dear sir, we do not eat 
uncooked rye. It is ground, made into loaves, and steril- 
ized in the oven. The people still die. No sterilization 
will render a diseased grain or a partially decayed potato 
perfect food product. 

Fondness of a bargain is likewise American. Suppose 
I have five tons of mouldy hay. It is sterilized after the 
most approved German method. Is there a physician in 
the land who will pay a full market price for this hay ? The 
hay is an imperfect food before a mould fungus starts. 
Killing the mould fungi does not restore perfect hay-. 

Milk secreted by a tuberculous animal is a diseased 
product — a diseased product before bacilli are found. Killing 
the bacilli by sterilization does not restore a perfect milk. 

Milk is a secretion — an elaboration — of principles from 
the blood. If the blood be pure, the milk is pure and vice 
versa. 



^-49— 

It is known that nervous impressions increase, dimin- 
ish or vitiate the milk flow. It is known that the milk of a 
syphillitic is poor in quality, and should be nursed only in 
exceptional cases. 

What shall we say of the milk of an animal suffering 
from a constitutional disease? To the writer, it seems a 
fallacy is foisted unwittingly on an intelligent public. 

Are there any little children in this land of plenty, who 
are calling for more? Herein lies a secret of the fifty per 
cent of mortality under five years of age. Believing this, 
could you conscientiously recommend condensed milk for 
children, gathered as it is from unknown sources? 

Poor as are all artificial infant foods — in that they do 
not contain the elements of nutrition — they are superior to 
commercial condensed milk, in that they do not contain the 
elements of disease. 

Some one may ask what is the chemical difference be- 
tween diseased and healthy milk. Some one may likewise 
ask what is the chemical difference between a diseased and 
a healthy potato. Cook them and your three-year-old child 
will see a difference. Use the two kinds of milk and you 
will perceive a difference. 

Have you ever said to a mother: "You must not 
nurse your infant. You are in ill-health. The milk is a 
diseased product." 

In the moral as well as the physical world no man 
should find fault with present conditions unless he be able 
to point out a better way. 

If pure milk be the only perfect food, if the infant 
human race must live on milk, the way to obtain pure milk 
is the desideratum of the century. 

1. We must have healthy animals. 

2. Animals must conform to hygiene. 

3. Every precaution must be taken to keep milk pure. 
How shall we obtain healthy animals ? What says the 

New York Health Board? "Use the tuberculin test and 
kill all diseased ones." To the writer this seems like cross- 



—50— 

ing the valley of Lethe on the bridge morality. The bridge 
— a very fine structure — stops in the middle of the river. 
In less than five years New York will again have to adopt 
the scientific method. 

While removing the diseased animals would it not be a 
higher wisdom to secure a healthy progeny by selection? 
Animals must conform to hygiene. 

It is astonishing how inconsistent we are. Mothers 
must be very careful of diet, etc., etc., while nursing in- 
fants. Cows are allowed to be crowded in filthy stan- 
chions, eat mouldy hay, drink stagnant water, without air, 
exercise or sunlight ; milked at all hours, the milk delivered 
twenty-four hours late, is sterilized and pronounced perfect 
baby food. 

The man who sells rotten bananas and robs you of 
your child is no more guilty than he who thus cares for his 
cows and spreads disease and death. They should alike be 
held amenable to law. 

r 

Every precaution should be taken to keep milk pure. 
Herein lies a field for sterilization. 

Look over the able articles written during recent years 
and you will readily glean a consensus of belief as follows : 
(a) Diet causes tuberculosis ; (b) diet cures tuberculosis ; 
(c) diet prevents tuberculosis ; (d) the same article of food 
taken in the same manner acts in the three ways men- 
tioned ; viz : a, b and c, at the same time, (e) Statistics 
prove all this. Our ascertained facts must be renovated. 
There is certainly something wrong. 

In what does the wrong consist? We believe it con- 
sists in a false conception of the nature of the disease, tu- 
berculosis. 

We are taught tuberculosis is an infective disease 
caused by the tubercle bacillus ; infective in the sense that 
one takes the disease from another; caused, in the sense 
that growing bacilli are commonly found in the disease. 
So long as these ideas entertain and hold there can be lit- 
tle true progress. To progress there must be a radical 



—51— 

change or rather interchange of ideas. Take the common 
food product, butter. No article of commerce is in more 
common use or contains greater number of tubercle bacilli. 
If present views be correct every time we partake of butter 
we are infecting our system with tubercle bacilli or causing 
tuberculosis. 

On observation it is evident : (a) That multitudes of 
people eat butter who do not take tuberculosis ; (b) that 
tubercle bacilli do not take root in the healthy human or- 
ganism. Hence (c) butter does not cause tuberculosis only 
in certain diseased conditions of the system. 

It follows : (a) Those having this diseased condition 
should not eat butter; or (b) should eat butter free from 
tubercle bacilli. 

The question now arises, what is this diseased condi- 
tion of system? 

How does it arise or how is it caused, and in what way 
may we prevent it? 

On close observation it is seen only those animals al- 
low the entrance of growing bacilli who in some way have 
suspension of atmospheric influence. If there be no suspen- 
sion of atmospheric influence there can be no tuberculosis. 

It is then a question of suspension or non-suspension 

of atmospheric influence, and not a question of eating or 
not eating butter; not a question, perse whether tubercle 
bacilli be present or absent in said butter. If the reasoning 
be correct, instead of a microscopical examination of butter 
to determine the presence or absence of tubercle bacilli, we 
should examine the family history or environment of the 
party eating butter. 

The same reasoning may be applied to milk. 

No greater fallacy exists than that milk causes tuber- 
culosis. Yet it will take years to teach the public to think 
otherwise, because we are so imbued with the germ theory 
of disease. The truth will at last prevail. Some time, sooner 
or later, we will know better. In the accepted way, we 
have spoken of diet as causing tuberculosis. Let us now 



—52—, 

refer to diet as a cure of the disease. It is observed by all 
clinicians that tuberculous patients recover most rapidly 
who have good digestion and assimilation. They who can 
eat food and digest it, increase in flesh and put on a healthy 
appearance. They are certainly getting better. Per con. 
tra, they who are scant eaters, or they who have poor di- 
gestion gradually lose in flesh and become worse. They 
lose in flesh from lack of nourishment and from the waste 
constantly going on. Herein lies the secret, if there be 
one, of the so-called cure. 

Diet of food, rich in fat, if readily assimilated, restores 
the waste constantly going on. Does it cure? 

It is certainly an efficient aid in cure. Should the 
cause of the disease be steadily at work, no true cure is 
effected by diet. 

Does diet prevent tuberculosis? That there be no mis- 
apprehension we refer to one or two writers as expressing 
a belief that it does. Is this true? "Next to a life in the 
open air, perhaps even more than that, the question of food 
is of the utmost importance in the prevention of tubercu- 
losis, as well as in the treatment of the disease." — Youth's 
Companion, March 31. 

Speaking of hygienic treatment: "Of equal impor- 
tance with pure air is the selection of proper food and its 
digestion and assimilation," etc. — Lancet-Clinic, Feb. 5. 

These writings are selected simply to show the trend 
of modern instruction. They express what is being taught 
on every hand : That proper food is equal to pure air as 
a preventive of tuberculosis. 

The writer thinks not. Proper food or diet per se will 
never prevent tuberculosis. Pure air per se will ever pre- 
vent tuberculosis. Taken together there is no equality. 

Improper or insufficient food causes inanition. 

Impoverished or impure air causes tuberculosis. 

In inanition there may be or there may not be tuber- 
culosis. 

In tuberculosis there is always inanition. 



—53— 

To briefly summarize : 

Diet does not cause, cure or prevent tuberculosis. If 
true, how can the action of a, b and c take place at one and 
the same time? If true, are tubercular statistics of value? 

What is tuberculosis? A constitutional disease, de- 
pendent largely on the evils of civilization and governed by 
the following law: The death rate from tuberculosis is in 
direct ratio to suspension of atmospheric influence. 



-54- 



THE CAUSE OF TUBERCULOSIS. 



United States Indian Service, 
Yankton Agency, 
Greenwood, S. D., August 24, 1898. 

Dear Doctor : — I have read with great interest your 
article in the last number of the Medical Record. I have 
held your views for some time. I have in my experience 
the best illustration imaginable. 

I have attended the Indians both here among the Sioux 
and in Idaho among the Bannocks. I have known many 
Agency physicians and have talked with them. All agree 
that the older Indians say they did not have consumption 
among them when they lived in teepees and in the open air. 
But as civilization advanced among them the government 
has constructed log cabins and small frame houses for 
them, and they have given up the teepee except a short 
time in the hottest weather of summer. Now we have con- 
sumption the most prevalent disease. More than half of 
the deaths are from it. 

In examining Indian children as to their physical 
fitness for school it is almost the rule to find tubercular 
glands in the neck or some evidence in the lungs. The 
joints of Indians and mixed bloods are rarely attacked by 
tuberculosis. 

These houses are mostly low, having one room ; many 
are log cabins with dirt floors, sealed as tightly as possible, 
the whole family living in this one room, and except in 
summer, cooking there on a large cook stove, heating the 
poorly-ventilated room to furnace heat, and after perspiring 
freely, going into the cold air. They are in the transition 
stage between savagery and civilization, mentally, morally 
and physically. This may account in some measure for the 
fearful hold this disease has on them, but I think tubercu- 
losis came with the house and "suspension of atmospheric 
influence." 



—55— 

Would it be wise to embody these thoughts, rambling, 
in a paper to help prove the great factor, suspension of at- 
mospheric influence? 

I trust you may find some interest in these remarks, 
and I thank you for the new light your valuable paper has 
thrown on the subject for me. 

Believe me, I am, very truly yours, 

Geo. F. Pope, M. D., Agency Physician. 

The above letter is self-explanatory. The article re- 
ferred to is found in the New York Medical Record of 
August 20, 189S, and is one of a series now numbering 
nearly forty. In these papers it has been the endeavor of 
the writer to express a continuity of thought and establish 
the law of tuberculosis. 

The law and the proof of its existence may be found in 
the Transactions of the Ohio State Medical Society (1893). 
So far as known no writer has attempted to controvert this 
law. Its author stands its champion and advocate. 

To some it may seem strange that disease obeys law. 
Why not? Is not everything in this universe subject to 
law? Why not disease? 

Malaria, the writer feels assured, is governed by law. 
He has so expressed himself in one or two published ar- 
ticles. So that whatever view may be entertained as to the 
Plasmodium of this disease, please remember there is a law 
of malaria. 

Cholera, the writer has long thought, is governed by 
law. The visitations of this disease are no mere chance 
visitations. Law underlies them in every instance. 

So we think in every disease there will be found a law. 
Knowing the law, w r e can the more readily control the 
disease. 

Medicine of the future will be largely preventive. In 
the past the effort has been to find a remedy that will suc- 
cessfully combat the symptoms of disease. This is well. 
We have a multitude of such remedies. In the future it 
will be the desire to determine the law that governs disease. 



—56— 

This will be better, in that we can the more readily predict 
the time, place and extent of disease zones. Then there 
will be less confidence in remedies and a greater confidence 
in means of prevention. All hail this happy day! It will 
surely come. 

Malaria is a disease whose treatment is fairly well un- 
derstood. In its worst type it is not considered a distinctly 
fatal disease. It is largely epidemic and its visitations are 
under control. 

Cholera is a disease to other climes, and visits our land 
only under certain conditions and after the lapse of years. 
With this disease we are not so much concerned. 

With tuberculosis the case is different. This disease 
is with us at all seasons and is extremely fatal. It takes 
our nearest and dearest friends, and when once its grip is 
felt its hold is seldom relaxed. It is a strangely fatuous 
'disease. The patient is ever having a slight relapse, never 
worse, gradually improving all the time, and dies in this 
belief. 

There is another fact. No treatment is of lasting ben- 
efit. The physician calls it a bronchitis, assures a cure, re- 
ceives a retainer, until he who runs may read tuberculosis. 

Nor is this act of the physician a mere love of gain. 
At first he believes what he says. He then modifies his 
prognosis as the disease advances. At last, for fear of com- 
petition, he holds his patient by mere force of will. He 
says in his heart : "I know you cannot be cured, but you 
must not be a patient of my competitor." What a shame ! 
Tuberculosis thus advances year by year without one 
thought of cause or cure. Of course, we are speaking of 
the rank and file of the profession. What shall we say of 
them whose title, dignity and rank but belittle the name 
they bear? "Miserable comforters are ye all." The classic 
lore still guilds the page, but blinds the intellect. When 
will ye be wise ? 

In the Medical Review, October 5, 1895, the writer 
recalled the words of the Psalmist : "He brought them 



—57— 

forth also with silver and gold; and there was not one 
feeble person among their tribes." The estimate being 
variously given as from one to two millions, where could 
we find such a people on the face of this earth to-day ? Cer- 
tainly, not among the civilized. 

He also recalls the statement of the classic historian, 
Lossing. Speaking of the Indian tribes embracing the 
greater portion of the north temperate zone, Lossing says : 
"Physical deformity was unknown, and there were few 
diseases among them." Could tuberculosis have been 
present ? We think not. 

Prof. Osier is also referred to in the same article as 
saying: "No race is immune. The Indians of this conti- 
nent are very prone to the disease. Matthews, whose ex- 
perience with the native race is large, states that the disease 
is on the increase among them." 

The writer asks, how is the disease on the increase 
among them? As thev come in contact with civilization. 

Listen to Osier's own words, same page (Practice of 
Medicine, p. 185, 1892) : "The death rate in the older res- 
ervations, as in New York, is three times as great as in 
Dakota." That is, the death rate is three times as great 
where the Indians are in contact with civilization three 
times as long; or, in other words, the death rate is in a 
direct ratio to contact with civilization. Could any testi- 
mony be more conclusive? 

Carefully read the above letter, and you have the un- 
asked testimony of one from the field. Is it not a satisfac- 
tion to know we have reasoned correctly? Is it not a 
greater satisfaction to see medical men in authority endorse 
the same view ? Would it not be a still greater satisfaction 
to see the dread disease, tuberculosis, banished from our 
midst ? It certainly would. It shall be seen, but perhaps 
not in our day. "The world do move." 

Turn back the page of history and walk with me in the 
streets of Ephesus. It seems but yesterday Diana, that 
ancient goddess, blindly ruled a queen. Around her stood 



—58— 

the workmen and knelt the votaries at her shrine. Who 
dare blaspheme her name ? The workmen saw that in their 
craft was gain. They wildly cried, "Great is Diana, the 
Ephesian goddess !" What now remains of this once lordly 
queen? Perchance a broken column proclaims the place 
she stood. 

The times have changed. We worship now around 
another temple. It is a German mosque. The worship is 
as senseless as of old, the gain far greater, the maddening 
cry of workmen yet more deafening. Who now dare speak 
against this altar? Here and there a still small voice. 
That voice will yet be heard. 

Along the shores of time are wrecks of theories. Here 
a broken rudder, there a mast, tell plainly of a palace in 
the years gone by. It long has disappeared. So will it be 
with this. 



—59— 
THE GERM THEORY. 



"And he sat in the tent-door in the heat of the day." — 
— Genesis 18:1. 

The text needs little elucidation. The one spoken of 
is no less a personage than the patriarch Abraham. Of all 
worthy historic characters none stand more prominent. 

Born in Ur, of the Chaldees, about thirty-nine hundred 
years ago, Abraham, under a providence, not his own, be- 
came wealthy and the head of a numerous household. 

We read : "The Lord had blessed Abraham in all 
things." 

It is not the purpose of the writer to dwell in detail, 
but his was a noble character, not perfect, but worthy of 
emulation. 

Two things are obvious : Abraham dwelt in a tent, 
and he rested at mid-day. 

The climate of Chaldea is such that life in the open air 
was common. Plainly, yet warmly clad, they dwelt as did 
their fathers, in tents and booths. Life to them was sweet 
in simple joys, which knew no after pain. 

Happy we, if in our race for greater joy had recognized 
the pain thereafter ! 

Man seeks greater closer habitations ; he builds a 
house. In building, had he kept the ventilation as in the 
tent or booth, all would be well. He builds regardless of 
an inner air, and garners as he sows — a spurious joy in 
dread disease — tuberculosis. In this we recognize a fath- 
er's care is greater than man's protection. This, we think, 
is wisdom. 

Abraham rested at mid-day. Some think he idly sat, 
while others worked. The writer does not think so. He 
had been working, but at mid-day, while the heat was great, 
sat resting in the tent. A lazy man can never rest. Some 
may suppose he sat and slept; the record does not say so. 
"And he lifted his eyes and looked and lo," etc., showing 
plainly he was wide awake — alive to duty. 



—60— 

Multitudes are sitting, idly dreaming of the castles in 
the air, while the few are slowly moving upward, step by 
step, the golden stair. Of this few was plain old Abraham. 

Let us pursue the picture : 

"And lo, three men stood by him, and when he saw 
them he ran to meet them," etc. 

May we not learn a lesson ? Abraham sat, and looked 
and saw and acted. Let us imitate his example. 

Perhaps to-day no one thing is receiving greater atten- 
tion from the medical profession than the germ theory of 
disease. Hundreds of Abrahams are sitting in their tents. 
Some, I verily believe, are resting. Many, wide awake, are 
looking with powerful microscopes and troubled gaze. Is 
the theory true or false ? 

What is seen? In diseased conditions certain germs 
or microbes at the seat of lesion. At times, one kind 
alone ; at others, more than one. 

What is seen ? Myriads of bacteria or growing plants, 
subsisting on diseased or worn-out tissue in frail, unhealthy 
patients. 

What is seen ? A growing vegetation in a fertile soil. 
This is seen on every hand. Along the shores of lakes are 
seen the shoals of many fishes. At times, one kind alone; 
at others, more than one. 

What is seen? Myriads of the finny tribe subsisting 
on the food there placed, or propagating species of their 
kind in favored places. This is seen. Abraham could 
have seen the same and that without a microscope. 

As the fish along the shore take up the food and prop- 
agate their kind, so bacteria in unhealthy tissue. 

Do bacteria cause disease? Another class are looking, 
with microscope as fair and eyes as bright. They say, in 
words our own, no microbe, per se can cause disease, unless 
said microbe be diseased itself. Wondrous knowledge ! 
My friend, good bye. How can we yet determine the sick- 
ness or health of any microbe. 

Let us pass on. In passing would it not be wiser to 



—61— 

assert that microbes are found in the environment most 
favorable to growth? The seed is scattered everywhere. 
It falls in fertile places and takes root. Growing germs are 
found where there is proper food ; where proper food they 
propagate their kind. 

Do they cause disease? Look again. "Bacteria in 
their growth develop toxines." If by toxines is meant 
vegetable poison or alkaloid; if by develop is meant store 
up in their substance, this statement is true. 

"These toxines are given off by the growing vegetable 
organism." Abraham, where art thou? This, the writer 
thinks, is far from the truth. He finds no such fact record- 
ed in nature. Living plants do not give off their alkaloids 
while growing. They give them up only by infusion or ex- 
traction. Illustration: Strychnia, morphia, atropia are 
vegetable alkaloids. Do the plants give off these poisons 
in growing? How utterly absurd! This the writer en- 
deavored to make plain some two years ago, vide "Status of 
the Bacillus." 

In order to be clearly understood, let us make a simple 
experiment. Put fifty pounds of rich earth in a box. Plant 
poppy seed in this earth. Place under the most favorable 
conditions of growth — light, heat, moisture, etc. The seeds 
germinate, the plants soon grow and develop to maturity. 
How do we obtain morphia? Is there a physician in the 
land unable to answer? Listen to the bacteriologist: 
"Plants in growing develop toxines. These toxines are 
given off in growth." 

How do bacteriologists obtain morphia? By collec- 
tion from air, earth or water? If not, why not? Do not 
plants in growing give off toxines ? 

The following bacteriological experiment is very com- 
mon : Into a flask containing a small amount of bouillon, 
put a number of living tubercle bacilli. Let them multiply 
for several weeks. Filter out all the bacilli and inject a lit- 
tle of the filtrate beneath the skin of a guinea pig. See how 
quickly it succumbs. This, they say, is proof positive the 



—62— 

plants give out toxines to the fluid in growing. The writer 
thinks not so. A plant in growing absorbs or inhibits the 
soil in which it grows. If the poppies in growing take up 
one ounce of soil, there is just forty-nine pounds and fifteen 
ounces left. If in growing they develop one ounce of 
opium, this one ounce is found in the plants. No where 
else. As the plant in the earth, so the plant in the bouillon. 

Have we made this plain? If so, let us take another 
step. 

One suffers from tuberculosis. Tubercle bacilli are 
growing in his system. How are the symptoms of the di- 
sease commonly explained? Toxines are developed by the 
growing organism or bacilli. These toxines are thrown off 
by the bacilli in growing and continually poison the patient. 
Reason says the proper way to treat the disease is to give a 
remedy that will neutralize the toxines as thrown off by 
the vegetable organism. 

The writer smiles when he thinks of such foolishness. 
He at the same time feels vexed that men high in authority 
should make statements so erroneous. 

What is tuberculosis? A constitutional disease de- 
pendent largely on the evils of civilization and governed by 
the following law : The death rate from tuberculosis is in 
direct ratio to suspension of atmospheric influence. 

In other words, tuberculosis exists before the entrance 
of the growing bacillus ; one has symptoms of the disease 
before there is evidence of the growing germ. 



63- 



ARTIFICIAL IMMUNITY. 



The world in many ways is growing wiser. A few 
centuries ago they little thought of the progress to be made 
in the arts and sciences, of the methods of travel, war, com- 
merce, etc., now in vogue. Could past generations rise 
and view the strides taken we think they would truly be 
illuminated. 

Medicine, like other things, has been moving. While 
here and there the movement is retrograde, the general 
trend has been ahead. Should those ancient gods or myths 
in medicine arise we think there are many things for them 
to learn. But hold ! Some boldly assert the dead already 
know more than the living. If true, they keep this knowl- 
edge to themselves. 

There is no reliable evidence to establish intercom- 
munication. We have little sympathy for thinking men 
who consult or worship dead medkal heroes. The writer 
believes a ''live dog is better than a dead lion." The light 
of these men went out in their death. It is seen only in 
their works — "Footprints on the sands of time." 

In mathematics certain facts are so plain they need no 
demonstration. Illustration : The shortest distance be- 
tween two points is on the straight line between them. 

Other facts equally plain are based on an assumption. 
Illustration: Two and two make four, i. e., according to 
our system of notation. 

We assume one is one. If one be two, then two and 
two make eight. 

These two forms of truth we will designate as innate 
and assumptive. The two forms are found in medicine. 

There is this distinction. Innate truth is accurate 
under all conditions. Assumptive truth may be or may not 
be accurate in these same conditions. There is a wide dif- 



—64— 

ference in the meaning. The one is truth, the other as- 
sumption. 

One who reasons and uses truth and assumption as 
synonyms may find fallacy in his conclusion. 

Have we made this plain? We believe that he who 
claims a possible immunity from tuberculosis by the injec- 
tion of an alkaloid of the plant tubercle bacillus is laboring 
under the mistake named — taking an assumption for a 
truth. 

If the writer be correct, the reasoning is of necessity 
fallacious. If assumption and truth be used synonymously 
one has no moral right to ask acceptance of his teachings. 
Let us be honest. 

In discussion one is apt to be carried away by the heat 
of argument and utter things which he would not in his 
more sober moments. This is true in all controversy. The 
fire which generates steam if too strong may cause an ex- 
plosion. No explosion is desirable. Let honesty of pur- 
pose and fervency of spirit be the motto. The subject de- 
mands it. 

With one-seventh of the death rate caused by this 
dread disease, taken largely from a people in the prime of 
life and otherwise well fitted for years of usefulness, let no 
man stand by the deathbed of his fellow and trifle or de- 
ceive. Rather let us be honestly in earnest. 

''Tuberculosis is caused by the tubercle bacillus." What 
evidence have we of this ? 

(a) Tubercle bacilli are found in the disease tubercu- 
losis. A murder is committed in a certain village. A, B 
and one thousand others are found in this village. Is this 

-proof positive that the one thousand and two committed 
the murder? Would any lawyer, judge or jury so regard 
it? Tubercle bacilli are found in health. Is their presence 
the cause of health? 

(b) Tubercle bacilli are found growing in tuberculosis. 
Please examine this answer carefully. We desire it. 
Rushes are found growing in a certain pond. Do the 
rushes cause the pond ? Is not the pond a suitable place for 



— 05 — 

the rushes to grow? In tuberculosis a diseased condition is 
present. The diseased condition is a suitable place for the 
tubercle, bacilli to thrive. Being found growing in this di- 
seased condition is no evidence these plants caused the con- 
dition named. How utterly absurd? That no one think 
the writer has gone daft on this subject, we herewith ap- 
pend the following letter : 

Colorado Springs, Col., October 8, 1898. 
Dr. H. H. Spiers: 

Dear Doctor : — I wish to say most positively* that in 
what you say regarding the cause of tuberculosis, etc., "I 
am with you,*' and that it is only a question of time before 
the whole truth will be known. I have studied consump- 
tion now for sixteen years, both in laboratory research and 
in a general practice among consumptives, and I have many 
facts to prove beyond question that the tubercle bacilli only 
attack a tissue prepared for it. Flies only "blow" a dead 
horse, as the cowboy says. 

Hoping to meet you some day, I am. 

Very sincerely, 

C. F. GARDNER. 

With the above statement before us we trust no one 
will henceforth talk of tubercle bacilli creating a soil in a 
healthy subject. They do no such thing. In every case of 
tuberculosis the soil is prepared before the bacilli take root 
and grow — prepared in one way — suspension of atmos- 
pheric influence. Hence the law of tuberculosis : The death 
rate from tuberculosis is in direct ratio to suspension of 
atmospheric influence. This law the writer has advocated 
for the past twelve years. If true, the disease tuberculosis 
can be controlled. 

(c) Tubercle bacilli or their pure cultures are injected 
into healthy guinea pigs. In every case these animals die 
of tuberculosis. This, says the germ theorist, is proof pos- 
itive the tubercle bacilli cause the disease. Let us examine. 
Admitting the injection causes the result named, it is nec- 
essary to show (1) the human race is a race of guinea pigs : 



—66— 

(2) the method of injection is nature's method. Neither 
can be shown. 

(d) Tuberculosis is infectious. Example : Mr. H., aged 
twenty-five, is in poor health. He marries a healthy girl. 
Two or three years later the husband is told by an M. D. 
that he has tuberculosis. Mr. H. takes but little medicine, 
confines himself almost wholly to the house, and the wife, 
who is very much attached to him, stays long in the same 
room and ministers to his wants. One year from his first 
illness he dies of tuberculosis. His wife dies of the same 
disease about six months later. The neighbors say, "She 
caught the disease from her husband." 

If one take the disease from another in what way is 
the infection conveyed? In other words, if tuberculosis be 
due to suspension of atmospheric influence, how can this 
suspension be conveyed to another person? Do not be 
too hasty in judgment. Let us hear a further recital. 

Mr. B., of P., aged twenty-three marries Miss T., of 
E. His family history is decidedly bad. At the present 
writing all the family — parents, children and grand-chil- 
dren, nine in number — are dead. The family tree is extinct. 
With but one exception all die of tuberculosis. One child, 
I think an infant, died of diphtheria. 

Mrs. B., his wife, aged twenty-one, is healthy, but 
never robust. About two years after their marriage Mr. 
B. dies of tuberculosis. His wife is very attentive in his 
sickness and does everything possible for him in her 
power. Eighteen years have elapsed. Mrs. B. looks older, 
but is in as good health today as in those days of her mar- 
riage. Will any M. D. in the land assign a reason why Mrs. 
B. did not take the disease? Do not be too hasty and we 
will recite another case. 

Mr. B., of E., aged twenty-two, of poor family history, 
imperfectly recovers from typhoid fever. Two years later 
he marries Miss H., of about the same age and of fair fam- 
ily history. They settle in the township of R., and build a 
new house. Two children are born of this union, the elder 
still living, though delicate ; the younger, an infant of six 



—67— 

months, dies of tuberculosis. The father dies of the same 
disease about six weeks later. Mrs. B. cares for both hus- 
band and child during their illness. Eight years have 
elapsed. A month or two ago I met this lady on the streets 
of this village, the picture of health. Why did the second 
Mrs. B. escape this disease? 

In both cases, narrated from life, the reason is simple. 
Need I explain? It is these little things which tell me the 
laws of tuberculosis must be true. It cannot be otherwise. 
How did they escape ? By having perfect ventilation in the 
rooms occupied. There is no danger whatever of "catch- 
ing" or contracting tuberculosis if the ventilation be per- 
fect. Why? Because the tubercle bacilli cannot create a 
soil in the healthy individual. The soil is created by sus- 
pension of atmospheric influence. Write this in your 
note book, I solemnly declare it is truth. How, then, does 
a wife or husband "take" the disease from a partner? By 
living in the same environment, which is an improper one. 
This truth was shown many years ago. We have referred 
to it before. We refer to it again : 

"From the statistics of the Brompton hospital, col- 
lected by Drs. Cotton and Edwards, it has been shown that 
of the many nurses and others engaged in that institution 
during twenty-one years, but one nurse and one servant 
died of phthisis. Especial care seems to have been taken 
in the Brompton hospital in regard to ventilation and other 
hygienic conditions. Dr. Cotton's expression is that 'a res- 
idence in the consumptive hospital and long-continued 
working in its wards is a very good way, indeed, not to 
catch the disease." (Reynold's System of Medicine, vol,, 
II, p. 117, revised by Hartshorne.) 

It is seen that especial care is taken in this hospital in 
regard to ventilation, etc. What other hospital has taken 
like care? What other hospital has a like record? It is 
not that we know less than formerly, but is it not true we 
have gone daft after a germ theory ; Is it not true our pres- 
ent system of medicine is so Germ -anized that we think 



—68— 

of little else except germs ? 

It is therefore seen if a, b, c and d are the valid reasons 
why tubercle bacilli cause tuberculosis, the statement that 
they do cause said disease is assumption. If assumption 
be used as a! synonym of truth, the conclusion is fallacious. 

To return, if tubercle bacilli do not cause tuberculosis, 
how can we rationally say their alkaloid affords immunity? 



— 09— 



THE BICYCLE A PREVENTIVE. 



The world moves on wheels. How rapid the pace. 

"Art is long and time is fleeting." 

As we look from our window and see the many swiftly 
gliding by on wheels, the question arises, how will the race 
be fitted for the "struggle for existence" in the years to 
come 

On the good to result from the use of the bicycle, as of 
other things, there is a diversity of opinion. Whether the 
bicycle prove a benefit or a curse will largely depend on its 
proper or improper use. Some predict a future race of 
humpbacks, with deflected spinal columns, etc. 

The writer takes a more hopeful view. He thinks as 
time passes the wheel will be made more specially adapted 
to individual Avants. Each person cannot wear the same 
clothes. Why should wheels be made so nearly alike? The 
tall and the stout, the lean and the obese should each have 
a wheel adapted to his needs. The novelty in use will wear 
away. Each will learn while there is celerity in movement 
and time saving in use, there is also a limit to physical en- 
durance. 

In the future we will be more conservative of our powers. 
Grace in riding will be sought in the future. We cannot 
all be handsome. It should be the aim to ever appear at 
our best. So that taking all in all, we are inclined to think 
many of the evils now existing in the use of the wheel will 
pass awav. 

Beauty in the wheel will give way to grace in riding. 
Rapidity in motion to comfort in using. Xovelty to utility 
and the world will be made better by its introduction. 

There is a phase in its use on which we wish to dwell. 
The wheel leads to out-door exercise. 

The toiling milliions have exercise enough, sav some. 



—70— 

Where is this exercise? In the dusty shop or ill-venti- 
lated hall. Mechanics, merchants, orators, laborers, all 
breathe an atmosphere absolutely impure. In this great 
world of ours, with the vast oceans to puriiy the air, should 
we breathe such vile stuff? No! A thousand times no! 

What are we doing in breathing impure air ? The lodg- 
ment of dust in the air cells of the lungs causes suspension 
of atmospheric influence from without. 

The inhaling of impure or impoverished air causes sus- 
pension of atmospheric influence from within. What does 
suspension of atmospheric influence induce ? The precedent 
state or condition ; tuberculosis in its incipient state 

What does exercise in the open air accomplish? The 
inflation of the air cells of the lungs and the inhalation of 
volumes of pure air. The preventio?i of the precedent state or 
tuberculosis. 

Who most readily takes tuberculosis? 

They who have the greatest suspension of atmospheric 
influence. 

Who most readily convey tuberculosis? 

The mothers of our land. Mothers, let us have more 
wheels. They prevent tuberculosis, the greatest evil of 
civilization and the greatest foe to the human race. 



—71— 



LEGISLATION. 



A legislator should be argus-eyed. All feel the burden 
of taxation, have ideas of just and unjust law, and recog- 
nize the worth of public officials. Taxation should be equal, 
laws just and officials honest. This the legislator should 
know. He finds it difficult to place the burden of taxation 
equally, to know at all times a just from an unjust law, to 
be strictly honest on every occasion. The law giver may 
strive to do his duty, fulfill all the necessary conditions, yet 
be misunderstood or misrepresented by many rivals and fail 
at the next election. 

These are a few of the trials or tribulations which every 
law giver meets. Truly, the legislator should be argus-eyed. 
He should have great wisdom. Legislation is asked on a 
subject of which little is known. This is an unjust demand. 
Education should precede legislation. The legislator has 
the right to ask enlightenment. A subject is clearly under- 
stood, yet there is a diversity of interest or opinion. One 
party asking, another denying, legislation. Here great wis- 
dom or its opposite may be shown. 

It is a function of the legislator to exercise tact and 
judgment. In the exercise of these success or failure is as- 
sured. Barring those cases of exceptional wisdom and tact 
in the legislator, legislation can advance no faster than the 
public sentiment which lies behind. In a republic we have 
no moral right to ignore our laws. It is we, the people, 
who make them. The legislator is only our instrument. 
He should be wise. 

We have spoken of honesty. Without this all other 
traits or characteristics will fail. No matter how wise, per- 
suasive or brilliant, if honesty be lacking, no worthy legis- 
lation can be assured. It may be said if one be wise, he will 
also be honest. Not necessarily so. There is a worldlv wis- 



dom without honesty; a love of office or power with evil 
intention. "A devil's purpose with an angel's face." 

If, then, we have correctly reasoned, three things are 
essential in the legislator, viz, many eyes, wisdom and hon- 
esty. 

Having spoken of the essentials in a legislator, having 
referred to the difficulty of always securing proper legisla- 
tion, and the necessity of education preceding it, we now 
take up a subject on which a great deal has been said, little 
formulated, and less put into execution. We refer to legis- 
lation on tuberculosis. 

Tt is the concensus of medical belief that tuberculosis 
can be controlled. The medical world is shouting this on 
every hand. Let the legislator ask the question, in what 
way can tuberculosis be controlled? Many are silent, more 
are indefinite, and a few continue to talk without ideas. 
Some physicians have this latter faculty in an intense de- 
gree. It is not a faculty to be sought in prayer. Our prayer 
should rather be, not more words, but ideas. 

It is evident the method of ridding ourselves of this 
deadly disease will depend largely on its cause. If we have 
a large vested interest in bacteria, having traveled and stud- 
ied extensively at great cost, no doubt it will measurably 
shock our sensibility and pride to be told that bacteria are 
of little worth in tuberculosis, and may be ignored entirely 
in the control of this disease. If the truth is to be spoken, 
let not a vested interest swerve us to the right or left. Leg- 
islators should be wholly disinterested. 

Again, if we hold a chair in some school of medicine, 
let not the emolument of office or the pride of power pre- 
vent the discernment of right and wrong. Let our motto 
ever be, learn to unlearn that which has been learned amiss. 
Knowledge sought and won in this way is power. To the 
thinker, no other knowledge is worthy a place. 

If rightly understood, we now have a wise, honest and 
disinterested legislator. He asks : "What is tuberculosis ?" 
We answer, a constitutional disease dependent largely on 
the evils of civilization, and governed by the following law : 



—73— 

The death rate from tuberculosis is in direct ratio to sus- 
pension of atmospheric influence. Please observe, in this 
answer no reference is made to the tubercle bacillus what- 
ever. 

According to the writer, then, the wise, honest and dis- 
interested legislator will take no cognizance of the tubercle 
bacillus in framing a law for the prevention of tuberculosis. 
All laws framed will be against the evils of civilization ; 
none against the tubercle bacillus. 

Says one : ''Do we understand there will be no legal 
notice taken of promiscuous spitting?" None, whatever. 
This, we think, is a proper subject for education, not legis- 
lation. People should be educated to be cleanly in their per- 
son, habits and environment. We think one could no more 
be legislated into cleanliness than into righteousness. Each 
is a subject for education. 

But says another: "Ts it not true that tubercle bacilli 
are continually floating in the atmosphere? Must we not 
prevent this?" Says the writer, it is true that tubercle bacilli 
are found in every atmosphere, more prevalent in some than 
in others. Two questions present : (1) Can we prevent their 
presence? (2) Would prevention be of value? On the an- 
swers given these questions must hinge ail law against the 
germ. 

In regard to the first, every medical man will agree 
that it is absolutely impossible to destroy all microbes or 
bacteria in the atmosphere. Why attempt the impossible ? 
Suppose we could destroy all bacteria in the atmosphere, 
what would it avail ? Bacteria are present in the food we eat 
and the water we drink. Suppose we could destroy all 
these ? If it be shown that tubercle bacilli do not cause 
tuberculosis, of what avail the destruction? The wide- 
spread disease tuberculosis would still be prevalent. With 
the premises before us, no other conclusion could be 
reached. 

The reasoning of the germ theorist is somewhat as fol- 
lows : Tuberculosis is caused by the plant tubercle bacillus. 



—74— 

The more plentiful the germ in the atmosphere, food or 
drink, the more prevalent the disease, and vice versa. 
Could we in any way diminish the number of tubercle 
bacilli, we could diminish the prevalence of tuberculosis in 
the same ratio. Germicides, control of sputa, etc., dimin- 
ish the number of tubercle bacilli per cubic foot of air space. 
Therefore, germicides should be used and the sputa con- 
trolled. These, therefore, are proper subjects for legisla- 
tion. 

This reasoning seems plausible, yet it is fallacious. Let 
us examine. In the first place, the prevalance of tubercu- 
losis is not in proportion to the number of tubercle bacilli 
in the atmosphere. Some will say at once that this is not 
true. It is true. 

We have already referred to the observations of Drs. 
Cotton and Edwards in the Brompton Hospital for Con- 
sumptives. Conditions in hospital, ventilation and hygiene 
good. Number of years in observation, twenty-one. Num- 
ber of attendants who died of the disease, one nurse and 
one servant. Conclusion: "A residence in the consump- 
tive hospital and long-contained working in its ward is a 
very good way, indeed, not to catch the disease. 

Take the same conditions except ventilation. Think 
you no attendants would have died? All attendants would 
have died of the disease. Why? Because imperfect venti- 
lation is suspension of atmospheric influence, or a condition 
in which the living tubercle bacilli enter the system and 
grow. 

In the two cases wherein is the difference? Opening 
or closing a window or door does not alone determine the 
absence or presence of tubercle bacilli in the atmosphere. 
How foolish ! There must be something else. What is this 
something else ? It is the perfect ventilation that renders 
the system immune. Here is the immunity long sought, 
not an injection. It is the imperfect ventilation that ren- 
ders the system a fertile soil. Hence the law of tuberculosis. 

The corrected proposition, then, reads : "The preva- 



— 10 — 

lence of tuberculosis depends on ventilation, not the num- 
ber of bacilli. " This is an important consideration, one 
which the biologist would do well to stop and investigate. 
We hardly look for this at present, he is so thoroughly im- 
bued with a germ theory. 

In the second place, tuberculosis is not caused by the 
plant tubercle bacillus. We have spoken of this in other 
places. We endeavor to be brief at this time. 

It is evident to any thinking mind that a plant cannot 
precede the soil in which it grows. Please consider : The 
tubercle bacillus is a plant, the soil is the being in which it 
grows. The being in health does not have growing bacilli. 
Why not? There is no soil. So soon as suspension of at- 
mospheric influence takes place in said being so soon a soil 
is present and so soon the tubercle bacilli take root and 
grow. Is this plain? When the ventilation is perfect there 
is no soil, and consequently no growing bacilli. This is true, 
no matter how few or many tubercle bacilli are in the atmos- 
phere. If, then, the ventilation be perfect, there is no dan- 
ger whatever of catching the disease tuberculosis. In this 
condition the tubercle bacilli are perfectly harmless. 

We are writing to rational beings. How, then, ought 
we to proceed? Attempt to destroy the harmless tubercle 
bacilli, or render the ventilation perfect? Which view ought 
to engage the attention of the wise, honest and disinterested 
legislator? There can be but one answer, legislation should 
be for better ventilation. Leave the tubercle bacillus alone ; 
it needs no care. 

In the course of events, as tuberculosis becomes less 
prevalent, through a purer atmosphere, the tubercle bacilli 
likewise becomes less. Whether few or many, it matters 
little if the ventilation be correct. 

What, then, shall we say of germicides and the control 
of sputa? Germicides are of little worth. It is not neces- 
sary to use them. Tuberculosis can be controlled in a bet- 
ter way. Every one should care for his sputa, but the care 
of it is not a proper subject for legislation. "Cleanliness is 



—76— 

akin to Godliness." Cleanliness should be taught. 

If the writer's conclusions be correct the reasoning of 
the germ theorist must be fallacious. What, then, is a 
proper subject for legislation? Ventilation. 

In order to present this subject in a clear light perhaps 
one or two illustrations would be proper. In referring to 
these it is not to condemn any particular system, but simply 
to illustrate. The cases chosen are the ones which come 
most readily to mind. 

In the elevated railroad of New York a method of 
rapid transit is in vogue that is unsurpassed in this country. 
The trolley or horse car of other cities is excellent. All 
these systems have one fault, viz., the ventilation of the 
crowded car is poor. The writer has been on the New 
York road when every inch of available space was occupied, 
no room to stand. The same may be said of the horse car 
line on Broadway as it was a few years ago. This condition 
of things ought not to be. The situation seen in New 
York is seen in many other large cities. Every seat in a 
car should have a proper air space for its occupant. Every 
occupant should be given a seat. Then the question of 
ventilation is settled at once and forever. The ventilation 
of the car should' also be perfect. In short stops and fre- 
quent changes this would be materially aided by frequent 
opening and closing of the doors. In long runs the case is 
different. Here the most perfect ventilation should be se- 
cured. One source of annoyance in long distances in the 
irritant dust. How to eliminate this and at the same time 
secure perfect ventilation is a question for science. Its 
present aim seems to be how best to catch, destroy or elim- 
inate the bacillus. The writer thinks its field of action 
should be changed. 

But ill-ventilation is not seen in the car alone. It is 
seen in the hall, church or shop ; in truth, wherever people 
congregate. It is also seen at the fireside in the home. 
When will we learn wisdom? "Wisdom is the principal 
thing; therefore get wisdom." 



—Ti- 
lt may be said the question of legislation, in regard to 
ventilation, is a complex one. It is complex, yet it is very 
simple. Pure air is abundant. It is also free. Why should 
there be difficulty in obtaining it ? The first question to con- 
sider is one of desire. Do we, as a people, desire pure air? 
If it be best for us to have it, if it be abundant and free, 
why should we hesitate? It seems to the writer it is a 
question of education alone. 

There are many things we earnestly desire. They can- 
not be obtained, or if received they spoil us or injure our 
health. When a necessary is to be had at so little cost we 
should reach out our hands and receive or demand it as our 
right. This is American. 

We are taking a journey. The car or boat or bus is 
crowded. One passenger desires pure air; the rest are 
satisfied as it is. The conductor or captain or cabman is 
asked to open a window or door. Many at once object for 
fear of taking a cold, and the window or door is closed. All 
suffer from the closure. Do we not need education? A 
consumptive or one having a cough enters this crowded 
car or boat or bus. He coughs or expectorates from neces- 
sity. The one in authority says: "Mv dear sir. or madam, 
you must not spit in this car." "Why not? Have I not 
purchased a ticket?" ''Your ticket is all right, but you 
must not cough and expectorate while on this car.'' "My 
dear conductor, why do you not give us pure air?" "You 
talk to the authorities about that." The authorities are 
investigated. "We are perfectly willing to conform to any 
reasonable public demand. Scientists tell us. there is great 
danger from dried sputa. It becomes disseminated through 
the air and causes consumption, etc. Scientists are silent 
as to ventilation." 

Do we not need education ? We certainly must educate 
before we can legislate. Legislation without public senti- 
timent behind it is a dead letter. Education and legisla- 
tion, like twin sisters, walk hand in hand. 

W hat, then, shall a traveling public demand of its car- 



—78— 

riers? Perfect ventilation, abundant air space and a seat 
for all. 

How shall we render our halls, churches, schools, etc., 
less dangerous ? By having them more perfectly ventilated. 
This can be accomplished in many ways : (a) Less seating 
capacity or larger air space ; (b) better heating apparatus, 
in that less atmosphere of the room is impoverished. /. e., 
by having greater heating surface and less intensity of heat 
less oxygen is abstracted from the air in the room ; (c)) an 
abundant supply of pure air partially warmed before enter- 
ing the room ; (d) an exit for all vitiated or impure air. 
These taken collectively, with a proper construction of the 
building or room, will fulfill ail needs. 

Many churches or halls are erected as to external ap- 
pearance or acoustic properties. While these must not be 
lost sight of, the ventilation of the building' is of far greater 
importance. The life of the audiences is of more value than 
the beauty of structure or voice of speaker. Architects, in 
making designs, should think of this. 

What shall we say of the home? Our home is where 
we live or abide. Where is the home? In the country or 
city ? Is it our own or another's ? Or, rather, do we hold or 
rent ? The answer to these must modify the answer given. 
If in the country there is greater opportunity to breathe 
pure air. The same may be said if the home be our own. 
In rented flats or rooms in the city we receive that for 
which we pay. If able to pay we receive the best ; if unable 
to pay we must take that which we can get. With the 
poor wage earners it is often take the poorest or none at 
all. How comfortless are these ! How illy ventilated ! 
Often, how short lived the occupants ! Cannot legal re- 
straint give them better homes? 

We have often thought in visiting country homes, what 
a field for cultivation ! How lovely and pleasant some of 
these homes are ! What taste and munificence ! Yet oft- 
times it is outward adornment like dressing the hair or 
body, not that inner fitness so essential to worth or useful- 



—79— 

ness. Seldom does the architect or builder think of that 
inner adornment — ventilation. What a pity ! In other 
homes, how destitute and comfortless ! The home is a 
mere hovel or shelter. 

It is not the elegant home that confers health and 
longevity. Frequently it is the poorest. One log cabin the 
writer recalls, which contained a large family. It was so 
open the stars could be seen through the wall on either side. 
Yet that family lived in that home many years. Little sick- 
ness, plenty to eat and do made that home a happy one. 
The family grew to manhood and womanhood, separated 
and organized homes of their home. How beautiful the 
picture ! This is not seen in every home. 



—80— 



CONTROL 



Of all historic diseases which have afflicted mankind, 
no continuous disease has been less subject to control than 
tuberculosis. There have been epidemics or endemics that 
were more fatal or less subject to control for short periods 
of time. But these have been only for short periods. These 
diseases die out for want of fresh fuel, or their very con- 
tagiousness has demanded great effort, which has resulted 
practically in control. 

With tuberculosis the case is different. This is a disease 
with which we all are practically familiar — one which every 
medical man thinks he understands. The very clearness of 
apprehenson with which he thinks he sees leads him blind- 
ly on in treatment or prevention. Hence no stop or cure. 

It is a common impression that tuberculosis is due to a 
germ. If true, the germ being killed the disease would at 
once cease. Methods of destroying germs are familiar to 
all. It is plain to the ordinary observer they are of little 
value. Germicides per se being valueless, it enters the 
minds of some that perhaps a condition of the system may 
be induced that will prevent the entrance of germs, or — 
may be better — will not allow their growth. Germ cultures 
are procured and their alkaloids used to fortify the system 
or render it immune. With a pains-taking accuracy worthy 
a better result, these germs are isolated, cultivated and the 
alkaloids injected for this purpose. 

The result is before us. Is tuberculosis lessened by 
injections of these cultures? There are many occupying 
chairs in medical colleges who would be pleased to answer 
in the affirmative, but facts do not bear out the assertion. 
Instead of boldly saying no, which would be the writer's 
course, the attempt is made to waive a direct answer to the 



—81— 

question and encourage a hopeful view for the future. At 
the same time these teachers are continually instructing in 
methods which have long since proved practically nil. 
Is such instruction a benefit? Finding it impossible to kill 
the germs in the air or in the person without injury, finding 
immunity largely an imaginary quantity, men have in some 
quarters advocated germ-proof houses. It is soon seen by 
all except a few fanciful scientists that even these germ 
proof buildings could be of little value. 

The question now arises : If present notions prevail, 
how soon will tuberculosis be under control? No one can 
clearly answer, for no one knows. Under the circum- 
stances, would it not be wisdom carefully to investigate 
the cause of disease and see if there be not some other con- 
necting or underlying condition which allows the living 
tubercle bacillus to enter one's system and grow? If such 
condition be found, would it not be further wisdom to in- 
quire if this condition is always present in the growth of 
tubercle bacilli in the human organism? If always present, 
would it not yet be further wisdom to ascertain if this con- 
dition cannot be removed, and thereby prevent the entrance 
of a growing bacillus in one's system? If this condition 
exists, is always present, is removable, we hold in our hands 
an effectual weapon for the prevention of tuberculosis. 

The writer claims that here is a succession of facts the 
force of which cannot be weakened by any argument. In 
other words, here lies a chain of reasoning on which the 
law of tuberculosis is based. This law is based on facts as 
immutable as in any law of Kepler or Newton. This law 
must stand. What is the law of tuberculosis? The death 
rate from tuberculosis is in direct ratio to suspension of 
atmospheric influence. 

Having laid down a law of tuberculosis, let us now 
critically examine the facts on which this law is based. 
My attention was called to these many years ago. The 
first published article bearing on the subject is found in the 
December number of the Cleveland Medical Gazette, 1890. 



—82— 

Phthisis pulmonalis is here spoken of as a zymotic disease. 
Medical experts had so placed it, and this opinion was ac- 
cepted without question. Upon investigation the contag 
iousness of the disease was in doubt. It was found there 
are certain conditions of the system in which one apparently 
takes the disease. There are other certain conditions in 
which one does not take the disease. The question arose : 
On what does the contagiousness or non-contagiousness of 
tuberculosis depend? In answer to this, it is seen that cer- 
tain animals are affected and the same animals are not af- 
fected, according to the condition in which they are housed 
or kept. Some in authority have lately asserted that food 
or diet has as much to do in the origination or starting of 
tuberculosis as has the atmosphere. The writer thinks that 
in this statement there is a misconception. It is not the 
atmosphere/^r se, but suspension of atmospheric influence 
that induces the condition or disease. Food or diet, ac- 
cording to quantity and quality, may improve or weaken 
the physical or mental condition. This, I think, is about 
all. Suspension of atmospheric influence, whether the ani- 
mal be weak or strong, will produce a condition of the 
system which allows the tubercle bacilli to enter and grow. 

While suspension produces a condition favorable to the 
growth of a germ, food produces simply a strong or weak 
condition of the system and has no relation to the germ's 
growth whatever. This, I think, is a marked difference, 
and one which even late observers have entirely overlooked. 
Again, it is evident that if the basic facts be changed, the 
law depending on those facts must be worked differently. 
This accounts largely for the change made in the law. 

Another fact may be referred to at this time. It is 
very difficult for some to enter into a discussion or investi- 
gation in which figures or mathematics are used. In order 
to accommodate this class, the law is stated in the simplest 
language possible. The writer feels assured that those who 
impartially investigate the subject will find the' conclusions 
accurate. 

With this simple law before us as demonstrated, with 



—83— 

the deadly disease before us as seen, it is the writer's hope 
and belief that much may be accomplished in a practical 
way by simply living in accord with the teachings of this 
law ; by avoiding in every possible way the suspension of 
atmospheric influence. A deadly enemy is before us. In 
every engagement thus far we have met defeat. Let us 
train our guns to do the most effective work. Before enter- 
ing in engagement it is always well to take an account of 
the character of weapons to be used. One great difficulty 
in the recent past has been that the bacteriologists have 
taken upon themselves the entire work. This I think is a 
mistake. Bacteriology is one arm of the medical service. 
Its work along its own line is of great value ; its work in 
other lines of no value whatever. 

To illustrate : We have many ships in our navy — bat- 
tleships, cruisers, torpedo boats, etc. Suppose a captain of 
a torpedo boat should say, a My boat will act as a battle- 
ship." Or the captain of a battleship should say, "My 
boat will act as a cruiser.'' Or the captain of a cruiser 
should say, "My boat will do the entire work; the rest of 
you may remain idle." What would be the condition of 
the navy?. Any one could see that the service would be of 
no practical benefit whatever. We might as well do with- 
out a navy as to have one boat arrogate the entire service 
to itself. Thus with bacteriology. Bacteriology has been 
pushed forward to the exclusion of everything else. I 
trust some of my contemporaries will see the force of this 
assertion. 

There is another insuperable difficulty which bacter- 
iology has met in the battle with tuberculosis. It is as- 
sumed that tuberculosis is a germ disease. If it were a 
germ disease, rationally considered, it could be met with 
germicides or the alkaloids of germs. It not being a germ 
disease, rationally considered, germicides or alkaloids of 
germs would be of no value. Whether the disease be due 
to a germ or not, I leave to an intelligent profession ; this 
much is certain, bacteriology has thus far found no cure for 
the disease. The same may be said of other methods of 



—84— 

treatment. The writer believes that the secret lies in rec- 
ognizing the cause of tuberculosis. It is plainly evident 
if the cause of tuberculosis be suspension of atmospheric 
influence, no line of treatment could cure without first 
recognizing the cause and removing it. Even then, if 
there be destruction of tissue, no treatment could restore 
tissue lost. These facts must be taken into consideration 
when talking of cure. So that he who asserts he has a 
cure for tuberculosis either falsifies or is ignorant. 

There being no cure for tuberculosis, it remains to be 
asked: In what way can we arrange our forces most ef- 
fectually to battle with the disease ? To the writer it seems 
clearly evident that the control of the disease must be 
largely along the line of prevention. Now do not misap- 
prehend. The writer believes that open air and constitu- 
tional treatment are of great value. In truth, in conjunc- 
tion, they are the best treatment of tuberculosis known to 
he science of man. At the same time, to repeat a well- 
worn aphorism : "An ounce of prevention is worth a pound 
of cure." There is no cure for tuberculosis. There is pre- 
vention. If prevention succeeds, there is no need of cure. 
Today this hydra-headed disease exists on every hand. 
There is need of prevention and there is also need of treat- 
ment. Insiduous and deadly in its nature, say not to the 
afflicted that there is no value in treatment. There is value 
in treatment. But if cure be perfected, treatment must be 
given in the precedent state or incipient stage of the di- 
sease. Then there is cure. But, as said in a previous ar- 
ticle, if there be disorganization or breaking down of lung 
tissue, this tissue can never be restored. Yet even in this 
condition treatment is of value and by its judicious employ- 
ment life may be prolonged, and aid and comfort given the 
afflicted. This alone is certainly worthy our consideration. 

To speak directly of prevention, the first step to be 
taken is to remove the cause of the disease. If the disease 
be due to suspension of atmospheric influence alone, the 
first step in prevention is to remove the suspension. With- 
out this nothing can be accomplished. With this much 



—85— 

can be accomplished. If due to heredity in conjunction 
with suspension, here the battle must continue as long as 
life lasts. Heredity is an entity of the parents, and must 
be controlled in the rising generation by proper marriage. 
Let no one marry into a consumptive family should he de- 
sire healthy offspring. Evidently the marriage relation is 
a serious one if we look at it in the light of transmission of 
disease. Even- one who asks in marriage should have a 
clear health register and he should expect the same of his 
partner. Without this tuberculosis will remain a disease 
in the human family to the end of time. With this tuber- 
culosis can be controlled. 

In a recent session of our legislature some one intro- 
duced a bill to regulate marriage. What became of the bill 
the writer only conjectures. One thing is known — the way 
in which the measure was received. Some spoke of it as 
ahead of the times ; others as visionary, unnecessary, ridic- 
ulous, etc. It is not worth while to discuss the merits of 
this particular bill. This much is certain : In the years to 
come some measure of this character will be enacted to 
prevent disease. Education must ever precede legislation. 
It is education today, legislation tomorrow. In this way, 
step by step, the human family has risen in civilization. 
The laws of Ohio today could not be enforced in present 
China. The laws of Ohio, it is hoped, will be changed for 
the better in the years to come. True, it is difficult to leg- 
islate on marriage. To say one must or must not is some- 
what arbitrary. Is it not best to do so? When one is edu- 
cated to select only the best in marriage, it is more largely 
a matter of choice or judgment and less one of impulse or 
emotion. Not long since a man of this city, pointing to a 
deformed child, said: "If nature could give me no better 
body than has that child I would ask to be shot." Please 
reflect ! What was nature's act other than the volition of 
the parents? Why not legislate? 

Reverting to suspension of atmospheric influence, this 
may be induced in many ways. The following classifica- 
tion presents the subject in the clearest light possible : 



-86— 



SUSPENSION OF ATMOSPHERIC INFLUENCE. 

f Impure \ m vent ii at i on vocation, etc. 
! atmosphere ( 
From without. ) Impoverished \ Over-heating rooms, im- 
{ atmosphere ( proper ventilation, etc 

p ... (Defective ( Original, j Heredity. 

From within. , { Disease, expos- 

^ & Acquired. / ure, etc. 

To explain more fully, suspension takes place in two 
ways — from within and from without. 

From within through original or acquired lung tissue. 
Though the scalpel or microscope may detect no difference 
in lung tissue, it is observed that children of consumptives 
take the disease more readily than children of the healthy. 
Why? Defective lung tissue — heredity. Such children 
will tolerate no confinement. Confinement to them means 
death from tuberculosis. These children die from the di- 
sease, while other children escape — ventilation, food, phy- 
sical exercise, etc., being the same ; thus showing that there 
is a difference in the organism or lung tissue. It is also ob- 
served that those having stenosis of the air passages wheth- 
er congenital or acquired, are more subject to tuberculosis. 
Why? Suspension of atmospheric influence. In some of 
these cases operation to remove the stenosis is beneficial. 
In all, there should be perfect ventilation. 

There are certain diseases which tuberculosis is pretty 
sure to follow if precaution be not taken, viz., measles, 
pertussis, etc. Why? Defective lung tissue — acquired. 
Suspension of atmospheric influence due to thickened lung 
tissue. What precautions are necessary? Perfect ventila- 
tion during sickness and recovery. 

From without, through impure or impoverished atmo- 
sphere. Every observer has noticed that there are two 
classes in particular who suffer much from tuberculosis — 
they whose vocation or calling keeps them continuously in 
the dust and they who suffer from confinement in ill-venti- 
lated rooms. In the first class there is suspension from 



—87— 

lodgment of dust particles in the air cells of the lungs or 
from mechanical irritation of the same — one or both, com- 
monly both. What is the preventive ? Avoidance of the ir- 
ritating dust. (1) Change of vocation, (2) wearing of a dust 
protector, (3) elimination of dust by a dust collector. 

If heredity be a factor, the first method should be 
adopted. No one should engage in or follow an unfavora- 
ble pursuit if the subject of hereditary influence. Though 
the usual precautions were taken, the probability is he 
would die of tuberculosis. If the subject be vigorous and 
have a good family history, he may follow the vocation of 
his choice. In this case a dust protector is of service, but 
unequal to a dust collector. In all shops where there is an 
irritating dust these collectors should be obligatory. 

We now reach the topic of impure or impoverished 
atmosphere. This has been explained elsewhere, but a 
word or two in this connection will not perhaps be out of 
place. We, as Americans, are living in homes many of 
which are warmed by furnace heat. In all homes there is 
artificial heat for a part of the year. In these homes the 
atmosphere is at times impoverished. As a result the oc- 
cupants suffer largely from respiratory and constitutional 
disease. Tuberculosis is of this number. It is prevalent 
and deadly. Treatment is of little avail. Prevention is of 
value. The preventive, the writer is inclined to believe, 
consists in a stove or furnace of at least double the size or 
capacity of the one ordinarily used. It takes no more fuel, 
the heat is more constant and even, and the stove or fur- 
nace lasts longer. There is, therefore, no greater expense 
in the end. There is an assurance of better health. The 
danger in cold weather is that too much oxygen is with- 
drawn from the room to support combustion, and not 
enough air is let in to replace the oxygen abstracted. Sus- 
pension of atmospheric influence is induced. In this way 
plants and animals alike suffer. 

There is another factor which should engage our atten- 
tion. I refer to the irritant dust of soft coal stoves and 
furnaces. In the present arrangement of these, nearly all 



—88— 

give off an irritant dust, smoke or vapor. Irritation of the 
throat, fauces and bronchial tubes commences soon after 
their use. This should not be. The draught should be 
perfect, so as to allow no dust in the room. If it is not 
perfect, there is suspension of atmospheric influence be- 
cause of the irritant dust ; also because of the lack of 
oxygen in the air. Consequent tuberculosis. When these 
facts are clearly understood and acted upon, the writer 
feels satisfied the death rate from tuberculosis will be much 
diminished. If true, this statement is worthy of considera- 
tion. In the above I refer to the atmosphere as found in 
country homes and villages. In large cities, as a rule, it is 
very much more impure. Large cities are railroad centers, 
contain the factories, workshops, etc. There are, of neces- 
sity, great volumes of smoke. At times the outdoor air 
is almost unendurable. Science can and no doubt soon will 
remove this smoke nuisance of cities. 

There are other factors, not mentioned, in cities which 
contaminate the air and render it unfit to breathe. I pass 
over these. One or two others I mention which aid respir- 
ation and whose absence makes breathing more difficult. I 
refer to public baths and gymnasiums. 

To conclude, if the person be kept clean, a certain 
amount of physical exercise be taken, and pure air con- 
stantly inhaled, there is no danger whatever from tuber- 
culosis if there be no heredity. Tuberculosis can be con- 
trolled. 



-89— 



STATUS OF THE BACILLUS. 



"The bacteria are now admitted to belong to the vege- 
table kingdom and to constitute the lowest forms thereof." 
— Dr. E. O. Shakespeare. 

There is a law of vegetable growth. Rationally con- 
sidered, the low form of organism or its microscopic nature 
does not militate against or invalidate this law. In other 
words, there are certain conditions which must be complied 
with in the growth of perfect vegetation. 

PLANT LIFE. 

(a) Conditions of Growth, Heat, solar or artificial, is 
necessary in the germination of every seed and in the fruc- 
tification of every plant. Without heat plant life or plant 
growth lies dead as inorganic matter. 

There must also be moisture. Heat may awaken a 
latent energy in plant life, but if continued without moist- 
ure the agency that awakens destroys. 

Light is also a potent influence. Heat may awaken 
life, moisture may continue life, light alone perfects and 
thereby perpetuates the life begun. 

In the continuation of plant life these three factors are 
always present, and, so to speak, in an intense degree. No 
one of the three factors can be ignored. The bacteriologist 
with his culture media, etc., etc., recognizes these princi- 
ples and applies them more or less in his field of labor. We 
say more or less. Heat is necessary; the temperature 
below a certain point little change takes place in the culture 
media. Moisture is necessary; no growth can develop with- 
out moisture. Light is necessary ; with a perfect action of 
the other two, light is essential to fruition. 

In the construction of the ordinary culture oven, if a 
provision be not made for the generous admission of light, 
will the vegetation be a perfect one ? At the end of an in- 



—90— 

definite series, a culture becomes attenuated. In what way ? 
There are many things a flood of light would illuminate. 

But hold ! The tubercle bacillus dies in the sunlight. 

"The tubercle bacillus dies under sunlight, in thin lay- 
ers in the course of a few minutes or hours, but perishes 
under diffuse daylight only in the course of a week." — Dr. 
Jas. T. Whittaker, Ohio Medical Journal, July, 1895. 

One other condition is necessary — a suitable soil. This 
will be referred to later on. 

(b) Modified by Environment . — Observe trees in a 
dense forest — tall, straight and without limb until near the 
top, in the crowded fence row — fan-shaped, with limbs to 
the earth; in the open — short, with branches extending in 
all directions. 

That a variable condition of the tubercle bacillus is due 
to environment is shown in an article in the Cleveland 
Medical Gazette, June, 1894, by Dr. C. W. F. Muenchehofe. 

(c) Elective in Location. — Sitting in a wood in West- 
ern Illinois I counted fourteen varieties of lumber trees on 
less than two acres in area. This is remarkable. Seldom 
do we see more than three or four varieties on so small a 
space. There are forests of oak, pine, cypress, etc. Often 
several kinds are intermingled, but usually one or two 
kinds predominate. 

The reason for this absence or predominance is prob- 
ably plant dislike or affinity for certain soils. We know 
from observation that native trees do not thrive equally 
well in all localities. There are certain spots in which na- 
tive trees refuse to grow. Change but a few rods distant 
and at once they begin to thrive. Seeds from forest trees 
are scattered year by year in these waste places. They fail 
to take root and flourish. The voice of plant life is the 
voice of the maiden : I marry, but not whom I dislike ; I 
grow but with affinity. 

In the distribution of bacteria many species are often 
found in the same tissue. 

"Different species of bacteria are so frequently asso- 
ciated together in substances that afford them nourishment 



—91— 

that some method of separation is essential for intelligent 
study, etc." — Dr. Shakespeare. 

At other times well nigh pure cultures are found. 

"The main habitat of the tubercle bacillus is the lungs 
and the sputum is sometimes almost a pure culture." — Dr. 
J. T. Whittaker. 

One of the greatest difficulties in the past has been to 
isolate in order to cultivate. It is thought this difficulty is 
now entirely overcome. 

With the removal of one barrier another appears. It 
is found the germ takes root in some soils and in some it 
does not. The reason for this affinity or dislike can only be 
conjectured. Instead of explaining in a perfectly natural 
way by saying it is owing to drainage or chemical constitu- 
ents of the soil, there arises the strange hypothetical doc- 
trine of phagocytosis, which is in substance that on the part 
of host and invader armed battalions are constantly on 
guard. On the least provocation a free fight begins. As 
neither party will yield, it is a war of extermination. 

It is readily seen how such a theory could arise on the 
continent. It is an every-day picture. It is not so clear 
how such a theory could become established among intelli- 
gent Americans. But it is simply wonderful the amount of 
trans-Atlantic idol-worship that is present among us. 

On this topic, as many others, revelations will arise. 
It is to be hoped they will be more in consonance with rea- 
son and common sense. 

(d) Absorption. — This topic is taken up with a degree 
of trepidation. Plant growth is shrouded in mystery. 
What the vital principle, when enters it the plant, how 
transmitted to the seed, death occurs in what way? — these 
and many other questions are as mysterious as life and 
death in the individual. 

The diversity in growth is involved in mystery. Two 
children, born of the same parents, reared with the same 
care, grow up together — the one virtuous, the other vici- 
ous. Mysterious ? Not more so than the growth of plants. 

Two seeds from the same tree are planted, the soil, 



—92— 

moisture and sunlight alike to each. The one is straight- 
grained, the other twisted. Mysterious ! Perhaps the 
child, by bent of inclination, received the vicious tendency 
and grew as moulded. Perhaps the embryo tree met some 
obstruction and turned in growing, remaining thus as tree. 
Mystery when made plain is mystery no longer. 

The growth of plants indifferently from the same soil 
is somewhat mysterious. The beech, the maple, the oak, 
grow side by side. It seems there must be a difference in 
the elements assimilated. 

How diversity of labor is performed on the same food 
is mystery. Three persons sit at the same table. One rises 
an orator, another a hod-carrier, the third a nothingness 
until the. next meal. It seems there must be a difference in 
the elements assimilated. 

There is a difference. All living organisms grow by 
absorption, or perhaps better, assimilation. 

To the vegetable world the soil is the food. Suitable 
soil means proper elements properly prepared. Whether 
the soil be prepared by the care or folly of man it matters 
not, nature appropriates as found. This thought should 
carefully enter the mind of every one seeking a cause or 
cure for tuberculosis. 

There is a difference. Each plant takes the element 
best suited to its nature, leaves the rest. One has more, 
another less. All must eat or die. 

Example : Mr. R. plants a field to corn for eighteen 
consecutive years. The. field is occasionally fertilized as 
others. Year by year the crop of corn becomes less and 
less. On the eighteenth year there is a good growth of 
fodder, but no corn. The soil for corn is exhausted. With- 
out fertilizer the same field yields a large crop of oats the 
ensuing season. Here is a lesson showing the value of 
rotation in crops. 

No doubt each tree takes nourishment appropriate to 
itself and leaves the rest. Another tree absorbs from what 
is left. In this is seen. a gathering up of all, or Nature's 
providence. 



—93— 

But, however rich a soil may be, it avails nothing to 
the growing plant unless it be rich in assimilable elements. 
To this subject my attention was early called in planting 
trees. All things considered, those trees grew best which 
were planted with the greatest care, in having all rootlets 
well cared for and the earth well pulverized around them. 
This much for soil constituents. 

In two articles on malaria, published in the Cleveland 
Medical Gazette, September, 1891, and April, 1895, the 
question of plant absorption of an element extraneous to 
the soil is dealt with. This must suffice for the present. 

Much as is known of the life history of bacteria, their 
growth is involved in mystery. Why arise these micro- 
scopic organisms? Is their office eliminative or destructive? 
Does their presence in disease constitute the disease per se ? 
When once in possession of a soil, can the soil be re- 
claimed? These and kindred questions may be asked in all 
earnestness, and yet the answer be a hollow mockery. 

The presence of the bacteria in disease — causal — and 
the presence of the same bacteria in health — harmless — is 
mysterious. 

Mystery made plain is mystery no longer. If we look 
upon the bacteria as vegetable organisms — and the highest 
authorities in the land view them as such — the way is clear. 
As already stated, all organisms grow by assimilation. The 
presence of a growing organism implies the presence of 
assimilable food. The presence of assimilable food implies 
a something bejore the organism tikes root. 

Which has the priority, the something or the organ- 
ism? Will some bacteriologist please tell us in what this 
something consists ? Mark the issue, in this something 
the cause of tuberculosis. Control this something and you 
control the disease. 

Can tuberculosis be controlled? Per contia, the pres- 
ence of a living organism — not growing — implies the con- 
ditions are unfavorable for growth, for it is as natural for 
organisms to grow under favorable conditions as it is for 
the sun to shine or water to seek its level. If, then, other 



—94— 

conditions be the same, in health as in disease, the growth 
not being the same, the cause or causes must be sought in 
the soil. Other conditions, light, heat and moisture, are 
supposed to be the same. A fair deduction then, is, the 
difference in growth is due to a difference in the soil. 

If, then, we take this rational view of the question, it 
is unnecessary to consider the hypothetical doctrine of 
phagocytosis at all. In other words, the peace of Europe 
does not demand an armed intervention. 

But say some, "The tubercle bacillus is a parasite." 
What is a parasite ? We will let the Standard answer : (1) 
"A living organism, either animal or plant, that lives on or 
in some other organism from which it derives its nourish- 
ment for the whole or part of its existence, as a louse, tape- 
worm, mistletoe or dodder." Yes, the tubercle bacillus is 
a parasite. 

One question please : Did you ever know of a person's 
head being so healthy that a louse could not live on it? 
Does the mistletoe invariably grow most luxuriantly on the 
tree half dead? Look around you. Did you ever hear of 
a tape-worm being found in a healthy pyimce vice f Does 
the potato beetle always select a sickly potato? 

"Come, let us reason together." 

Why does the tubercle bacillus select a sickly subject? 
Why does the tubercle bacillus fail to grow in the healthy 
subject? 

"Your reason, Jack, your reason." "What ! upon com- 
pulsion ? 

Yes, armed phagocytes at the portals. 

The changes produced by the tubercle bacilli are mys- 
terious. 

"The body which we term a 'tubercle' presents in its 
early formation nothing distinctive or peculiar, either in its 
components or in their arrangement." — Dr. Osier. 
i. e., before bacilli enter or are planted, "tubercle" is the 
same wherever found. The bacilli enter. 

"The bacilli then cause, in the first place, a prolifera- 
tion of the fixed elements with the production of epithelioid 



—95— 

and giant cells; and, secondly, an inflammatory reaction, 
associated with the exudation of leucocytes. How far the 
leucocytes attack and destroy the bacilli has not been defin- 
itely settled."— Dr. Osier. 

The writer has a simple taste, but he thinks when a 
plant takes root it begins to grow; that in growing it ab- 
sorbs nourishment from the soil; that whatever the plant 
gains the soil loses. There must be a change while the 
growth is going on. Change can be detected. 

All pathological talk has been on what is found in or 
after growing. What is taken up by the plant? What is 
lost to the individual ? These are questions that should be 
answered. 

The "agreement" of modern pathologists is mystical. 
Illustration : 

"Modern pathologists have agreed in this, that only 
such products, though histologically the same or similar, as 
contain and result from the specific bacilli, deserve the 
name of tuberculosis. Thus tuberculosis is defined an in- 
fectious disease." — Dr. A. Jacobi. 

Suppose the farmers of Ohio should agree that, inas- 
much as a horse has so many excellent traits, he shall hence- 
forth and forever be called a man. As a result of this agree- 
ment would the horse hereafter walk on two feet ? 

While it is perfectly right and proper for the patholo- 
gists or farmers to act in the premises, their action or in- 
action makes no change as to facts. The horse still re- 
mains a horse. Pathological agreements are not solid rock 
against which the medical writer can indifferently place the 
Archimedian screw. 

This is a question of mal-absorption or assimilation. 

Theological writers have been accused of cultivating a 
third eyelid. Medical writers have, and use, only two : 
Schliesze beide Auglein zn. 

(e) Diffusion. — The earth teems with life in the spring- 
time, when plants drink the moisture and sunlight. The 
air teems with life in the summer, when plants give the 
world their fragrance. 



—96— 

Plant Absorption and Diffusion. — Thus is taught a 
great lesson in nature : Secure, give. Man has perverted 
this lesson : Acquire, hold. 

It is not primarily a lesson in charity we desire to 
teach; the rather, to study plant diffusion and observe the 
lesson therein taught as closely as we may. Perhaps this 
study can be introduced in no better way than by an illustra- 
tion: 

The city of Ravenna, O., has a water supply inferior 
to none in the State. Drawn from Crystal lake, it is dis- 
tributed through mains to various parts of the city. Being 
soft, clear and pure, it is satisfaction to all who use. At a 
certain season of the year, and for eight or ten days, usu- 
ally in July and August, the water has a peculiar taste. I 
am told this taste is due to vegetation in the lake, which 
blossoms at this period. Since the intake has been supple- 
mented by wells in the immediate vicinity of the lake the 
taste of the water is not so marked at the period named. 
At any rate, if my informant be correct, here is a clear case 
of plant diffusion through water. The aroma of flowers, 
of birch, pine, etc., is familiar to all. 

Diffusion Through the Air. — If our senses were acute 
enough to perceive them, no doubt constant change could 
be detected in the soil, due to plant absorption and diffu- 
sion. Our natural sense is too dull to perceive them, and 
the chemist is baffled in detection. 

Query : If growing plants diffuse an entity to sur- 
rounding media, cannot the same action take place within 
as without, the body? Or to put the question more direct- 
ly : If growing plants diffuse to a fluid media, cannot living 
bacteria diffuse to the fluids of the body? 

If yes, may not these diffusions markedly affect the 
organism containing said bacteria? 

Let us examine. 

"Recent chemical examinations of the contents of pure 
cultures of various pathogenic and a few other bacteria 
have shown the existence therein of certain peculiar pois- 
ons, not only possessing, specific physiological action, but 



—97— 

also having peculiar chemical properties and constitutions 
which ally them more or less closely to certain well-known 
poisonous vegetable alkaloids. These chemical bodies have 
been named ptomaines." — Dr. E. O. Shakespeare. 

The willow is a native tree of North America. In the 
United States many of these trees grow along the banks of 
the smaller streams. As an anti-periodic the willow has 
long been known. The medical properties are found in the 
bark. In 1825 Fontana declared the active principle to be 
salacin. Ptomaines and salicin are then similar in each 
being developed in the living plant. 

"Pathogenic bacteria have been killed in their pure 
cultures by the action of heat. * * * The culture med- 
ium then injected, produces a series of symptoms, etc." — 
Dr. Shakespeare. 

Willow trees may be boiled, i. e., a decoction of willow 
is made. Its administration, per orem or injection, pro- 
duces a series of symptoms, and acts as an anti-periodic. 
Similarity is here closely allied. 

"Again, these pathogenic bacteria have been removed 
from the fluids of the pure cultures by means of filtrations. 
The filtered fluid has been inoculated with similar results." 
— Dr. Shakespeare. 

A filtration of willow yields an anti-periodic. Listen 
to the conclusion: 

"From these reasonings it would seem probable that it 
is the alkaloid developed by the growth of the bacterium 
which is the specific active agent in the production of the 
disease." — Dr. Shakespeare. 

— i. e., the writer takes it, the alkaloid passes from the 
growing plant into the fluids of the body and causes the 
disease. 

An Ideality. — John Smith, M. D., has long been a 
delver of German medical literature. He owns a farm in 
Ohio. Through this farm runs a small stream. Along 
the stream are many clumps of willow. The banks of the 
stream are shaded near its entirety. John has peculiar no- 



—98— 

tions. He drinks deeply of the fatherland. His reasoning 
is as follows : "Salicin is made from willow. In order 
to procure salicin the willow tree is destroyed. Why this 
waste of timber ? German medical literature says salicin is 
continually passing from the willow to the soil. If to the 
soil, then to the stream, for it cannot pass through the un- 
derlying clay. Why not boil the water and procure salicin 
from the stream? A perpetual annuity." John Smith es- 
tablishes a plant for the manufacture of salicin. We will 
not speak of its capacity at this time. For some reason it 
has not grown rapidly. The neighbors think John in the 
borderland of de??tentia. 

What shall we say of our dear German brothers and 
many American followers ? 

A truth is impressed which should be known to every 
observer. The fact that a plant develops or manufactures 
and stores away an element or principle in its organism 
while growing is no evidence this element or principle is of 
necessity given out in its life to surrounding media. 

As John Smith, M. D., is wrong in his reasoning that 
salicin is given off by the growing willow, so is every one 
wrong who assumes a living plant throws out its alkaloid 
during life. The writer thinks it does no such thing. 
That a plant which contains an element or principle may be 
made to yield the same by some method of filtration is 
plainly evident. That the plant tubercle bacillus does yield 
such an element by heat and filtration is known to every 
scientist. This element is the much vaunted tuberculin, 
the so-called remedy for tuberculosis. The failure of this 
remedy has been an ignominous one. Yet through all we 
see the savant Koch the least to blame. He thought he 
had secured a remedy for tuberculosis. Honest, though 
mistaken, mankind is fallible. Let it pass. 

John Smith, M. D., failed in the manufacture of sali- 
cin. He at once converted the plant into one for the re- 
moval of the willows. . He reasons thus : "Tuberculin is 
very efficacious in the sloughing of superficial tubercular 



—99— 

tissue. Tuberculin is the fluid extract of the plant tubercle 
bacillus. Salicin is the alkaloid of willow. Salicin is solu- 
tion ought to cause sloughing of superficial willow roots in 
the soil/' 

Some people are always doomed to failure. John has 
met success at last. He says the solution is efficacious, but 
succeeds best if poured on the willow roots while very hot. 

In the judgment of the writer, Dr. Shakespeare is right 
in calling the ptomaine of bacteria an alkaloid; wrong in 
supposing the alkaloid passes from the growing bacterium 
to the fluids of the body. 

Say some, if tuberculin is a failure in the treatment of 
tuberculosis, it still remains the best agent known in the 
diagnosis of the disease. A locksmith is working eight 
years in the perfection of a burglar proof lock. He an- 
nounces the lock ready for trial. A committee examine the 
same and report the machine of no value as a lock, but 
in the meantime find and add: It is an excellent plaything 
for. the baby. 

What do you think of the report as to the lock? 

So soon as treatment demonstrated tuberculin of little 
value, one would naturally think the use of the vegetable 
extract would wane. On the contrary, advocates rise in a 
night, like mushrooms in a pasture, and the remedy sells at 
fabulous prices. It is, then, not a plant diffusion, but a 
diffusion of microscopes of high power. Money flows into 
German coffers. 

Ladies and gentlemen of the profession, in all sincer- 
ity, is it not high time to call a halt ? Are we professional 
thinkers, or are we incorrigible asses? 

(f) Diffusion. — Microscopy as a science has done much 
to increase medical knowledge. Its use is recognized and 
its revelations regarded as of intrinsic worth. By its means 
certain diseases are now clearly diagnosed which were for- 
merly obscure. Organisms have been discovered and de- 
scribed which hitherto existed only in belief or imagina- 
tion. The road of the intellectual practitioner has been 
made plainer and more perfect, the thoughts elevated to a 

LofC. 



—100— 

higher plane. No one today decries the use of the micro- 
scope. It has come to stay. 

Medical chemistry is also a welcome guest. During the 
last two or three decades its strides in behalf of an advanced 
profession have been great. It has opened a way by means 
of which many urinary and other diseases are clearly recog- 
nized and ameliorated. Its aid to the practical diagnosti- 
cian in many cases has been immense. As medical prac- 
titioners we are debtors and feel kindly for its guidance. 
Like microscopy, no one fully educated speaks lightly of 
the clearness of vision it gives in apprehending so complex 
a subject as suffering humanity. 

Microscopy and chemistry, as enlightened practition- 
ers, we welcome you. 

But great as microscopy and chemistry enlarges our 
field of usefulness, something more is required than these. 
Microscopy or chemistry did not suggest gravitation to 
Newton or the glacial theory to Agassiz. The clear per- 
ception and description of animal life by Darwin was not 
given by either. 

Professional men are apt to forget and must be contin- 
ually reminded that the field of medicine is a broad field. 
He who reasons must reason from no narrow or special 
premise. The premise must be broad as the conclusion. 
The writer thinks the narrowness of the premise is a lack in 
modern methods. With this breadth of reasoning there 
must likewise be an acute observation. Without the latter 
all reasoners are apt to fail. Broad education and acute 
observation are two essentials in the advancement of medi- 
cal science. The possession of these, with a love for the 
work and an earnest desire to search only after truth, the 
progress in medicine is assured. 

There are at present two prevalent ideas. For the want 
of better terms we will name them the specialist idea and 
the generalist idea. The one is a specialist, the other a 
general practitioner in medicine. Each reasons from his 
especial field. Both claim accuracy. The specialist claims 



—101— 

prestige in his particular field. This is right. Work along 
particular lines ought to be better work. The generalist 
claims a greater outlook. This is right. One looking from 
many points has a clearer perspective. 

Some one thing is sought in a certain field. Who best 
to seek? The specialist. Something is found requiring 
determination. Who best to determine? The specialist. 
Some one thing being found, who best to generalize and 
assign its field? The generalist. Something being deter- 
mined, who best to name its systemic action ? The gener- 
alist. Thus each has his field of labor and each works best 
in his especial line. l 

The microscope reveals a plant life in tuberculosis. 
Had not this plant life been so revealed it might never have 
been disclosed. Thanks to the specialist. This plant life 
is proclaimed the cause of tuberculosis. By whom? The 
specialist. Is he now in or out of his especial line? If out, 
how shall we regard his judgment? The plant tubercle 
bacillus is analyzed. An alkaloid or ptomaine is discov- 
ered. This alkaloid is declared the active cause of symp- 
toms in the disease. By whom? The specialist. Is he 
now in or out of his especial line? If out, how shall we 
regard his judgment? 

W r ith these facts before us we claim acute perception 
or observation will do more in the solution of tuberculosis 
or, if you please, will do more for a suffering humanity 
than all speculations in existence. By observation it is 
seen (1) that the plant tubercle bacillus grows in certain 
soils — none other ; (2) these soils are prepared for the nat- 
ural reception and growth of the bacillus in one way — none 
other — abeyance of atmospheric influence. Place these 
two propositions together and then ask, can tuberculosis 
be controlled? 

What has this to do with plant diffusion? This is a 
diffusion of plant ideas. 

It is seen, then, that fitting or preparing a soil is all 
that is necessary. If this be all, how does plant life come 



—102— 

into. existence? This may be answered in the simplicity of 
Topsy in "Uncle Tom's Cabin/' "I spec's they growed." 
No one truly plants bacilli except the bacteriologist. He 
plants when, where and how he pleases. Selects and fits 
his own soil, cultivates or not as he deems proper, and 
reaps his reward — a harvest of bacilli. The world is little 
wiser. Did I say no one plants except the bacteriologist? 
Let me correct this statement. Every one plants who fits a 
soil, whether it be in his own person or the person of an- 
other. There is this difference — the planting of the bac- 
teriologist is an artificial one ; the planting as seen around 
us is a natural one, induced by artificial life. The one is 
an artificial soil selected by man's care, the other an arti- 
ficial soil induced by man's folly, the one an artificial soil in 
that nature does not lurk in wait with culture media and 
hypodermic needle, the other an artificial soil in that nat- 
ural soil has no growing bacilli. Both are artificial in the 
sense of being either selected or induced. 

You say that preparing a soil is all that is necessary. 
Can a natural soil be prepared ? Yes, in from one to twelve 
weeks if the environment be favorable. What is meant by 
environment ? Illustration : Take monkeys from the forest 
— tuberculosis unknown among them since the days of 
Adam. Place them in close rooms and examine them from 
week to week. What do you find? They are dying of 
tuberculosis. Perform the same with other warm-blooded 
animals, as man. A similar result. How do you account 
for it ? Can you secure the same result by any other means 
if you allow the animal free access to the open air? But, 
says the bacteriologist, the close room means not only sus- 
pension of atmospheric influence, but also the presence of 
the bacillus. Eliminate the bacillus and will the animal 
then die of tuberculosis ? The reply must be similar in na- 
ture. Are we not told the bacillus is ubiquitous ? Is it not 
everywhere present ? Can we by any possible means control 
its absence or presence ? What is the use for one to ask the 
impossible? If the tubercle bacillus truly causes the fatal 



—103— 

disease — if we cannot prevent its presence — what is the use 
of being foolish ? What we can?wt amend we must e?idure 
We mzist abide the presence of the baccillus and that which 
it causes — tuberculosis. There is therefore no hope from the 
ravages of this most intractable disease under present teaching. 

This seems probable from an examination of the death 
rate from the disease in Germany, the so-called medical 
center of the universe. The American mind is pre-emi- 
nently practical. "The way to resume is to resume." 
Why not practical in the management of tuberculosis? It 
is seen there must be a peculiar or particular soil before the 
growth of the bacillus takes place. This soil must precede 
the advent of the germ. Why not control the soil and let the 
germ take care for itself. 

Suspension of atmospheric influence being the cause of 
the primary condition or precedent state, it is plainly evi- 
dent the character of the soil is under control. The soil 
under control, the disease is under control. This, the 
writer thinks, is the only effectual common sense method 
of controlling the disease. 



—104— 



ABEYANCE OF ATMOSPHERIC INFLUENCE. 



While attending lectures at Ann Arbor, Mich., in 
1874-5, Prof. Ford clearly and forcibly demonstrated the 
nature of lung tissue. Speaking of its tenuity, he com- 
pared it to the finest tissue paper in existance. The paper 
maker's art has advanced in twenty years, but normal lung- 
tissue remains the same. 

Into and through this tenuous tissue courses the life- 
giving principle, the blood; into and through this tenuous 
tissue passes the life-giving principle, the oxygen. The 
one surges from within at every heart-beat, the other surges 
from without at every inspiration. 

It is seen that in order to have perfect aeration there 
must be a normal lung tissue, a heart-beat that sends a con- 
tinuous stream of blood to every part of the lungs, an in- 
spiration that renews continually the atmosphere of the air 
cells — yet something more, the joint and harmonious action 
of the two, or a correlation of force. If from any defect in 
the organism, original or acquired, the blood or air does not 
reach the lungs at proper times or in proper quantities, 
aeration is defective. 

Perfect aeration means more than this. It involves a 
perfect machinery or organism plus a pure atmosphere. 
Aeration in other words is ventilation of the blood as it 
flows in the life current. As the river in its onward flow 
receives the oxygen of purification, so likewise the blood. 
The completeness of aeration is proportional to the com- 
pleteness of ventilation. If, then, the writer clearly appre- 
hends perfect aeration, it embraces primarily a normal lung 
tissue, a correlation of force and a pure atmosphere. 

While it is true digestion, circulation and aeration are 
performed by separate organs in the economy, no> organ can 



—105— 

say its action is alone. Each is dependent on the other. 
So with the lungs. A healthy organism is then presupposed. 

The stomach, heart and lungs being supplied with the 
same arterial blood, other circumstances equal, one would 
rationally consider the function of each equally well per- 
formed. The same is true of other organs. But the nerve 
supply, which seems to designate or determine the work or 
conditions of work for each organ, is very different. So 
also is the work each organ is called to perform. 

While the stomach, heart and lungs are supplied with 
motor branches from the pneumogastric — a cranial nerve — 
the organs of respiration are also furnished with sensitive 
branches from the same nerve. In other words, it seems a 
design of creation that the brain should control respira- 
tion. Yet not entirely, for it is seen that the three organs 
named are also supplied with branches from the sympathetic. 
But they are supplied in a very different manner, as one 
would naturally infer from the nature of the work required: 

While the stomach has a comparative paucity of plex- 
uses and ganglia, the heart has an extensive system — a 
complicated net-work — in this regard. The lungs are 
marked by ganglia on all filaments extending to the bron- 
chial tubes, and as stated, by a combined system of motor 
and sensory nerves. 

In looking over the nerve supply of the various vital 
organs one is led to inquire who can interpret the nerve 
factor of any. In attempting a solution, difficulties at once 
arise. To interpret, all the organs must be taken into ac- 
count. Imperfect knowledge of nerve supply and office, 
imperfect interpreters, etc., are some of the difficulties we 
meet. But this much is certain : The nerves are the lines 
of communication, near or remote. Sever those lines and 
communication is at an end. Suppose, instead of cutting 
the lines, we so obstruct as to break the connection. The 
result is the same, though slower. In the lungs there is 
the motor and sensory fibers of the pneumogastric. We 
inhale or exhale, forcibly or otherwise, as we choose. In 
health it is a matter of volition. Sever or obstruct one or 



—106— 

both of the nerves controlling respiration and the breathing 
is laborious, or under control no longer. In disease of this 
nerve, respiration is not a matter of volition. We may will 
to breathe deeply or otherwise, but have no power to exe- 
cute. The same or similar condition maintains if the brain 
or ganglia on the nerve trunk be diseased. The telegraphic 
connection is stopped or is not under perfect control. 

Again, we inhale something that irritates our lungs. 
We cough persistently, even though we desire to stop. No 
doubt it is the little tell-tale ganglia on the nerve filaments 
of the bronchial tubes that are kindly telling us of the irri- 
tation. We are admonished in this way to remove it. If 
the nerve filaments or ganglia be diseased the irritant may 
be present, yet we are not conscious of it. But mark — the 
injury entailed remains the same. 

Having tried to make plain the central and peripheric 
nerve influence, let us now consider the essentials to perfect 
aeration, and at the same time study the defects that cause 
abeyance of atmospheric influence. We do this the more 
cheerfully, for on this topic, it seems to the writer, there is 
gross ignorance and a degree of mental hebetude inconsis- 
tent with civilization. 

There is a period of growth or development in all exis- 
tence. We see this on every hand. The human system is 
no exception to this law of creation. The number of years 
allotted to man has been variously estimated by different 
writers. It seems that, while there is a general average of 
life, there can be no law that will apply to every individual. 
Each human being has a life distinctly his own. As no 
chain is stronger than its weakest link, so no being is 
stronger than his weakest organ. When we see a race, 
family or individual prone to a certain disease, we can ac- 
count for it on no other than rational principles. There can 
be nothing accidental regarding it. It must be due to 
heredity or causes external or internal. If due to heredity, 
by following up certain family lines or connections, we find 
the same disease. If, as we trace this disease back, we find 



—107— 

it more or less prevalent or malignant, we make deductions 
accordingly. These are generally correct. 

There is a tendency on the part of some to speak of 
heredity as a sole causal factor in diseases showing trans- 
mission. This seems a mistake — an error that needs cor- 
rection. Should a parent have lung disease, should his 
children to the latest generation have the same disease at 
birth, one could reasonably attribute all disease of like na- 
ture to heredity. Observation does not confirm this state- 
ment. A parent with diseased lungs, or lungs of abnormal 
tissue, may transmit weak lungs, or, probably better, lungs 
of abnormal tissue. Observation shows this to be true = 
Both parents having weak or diseased lungs this claim is 
doubly sure. Of either parent — the mother most certainly 
— transmits the weakness as I have elsewhere shown. This, 
then, seems a law of heredity : Like transmits like. 

Why certain mental or physical characteristics or con- 
ditions, etc., are transmitted may never be fully explained, 
but their transmission cannot be denied. 

Is there another factor that aids heredity? Suppose a 
cause be shown for the lung disease already spoken of. Sup- 
pose this cause is constantly at w r ork. The following would 
then prevail : Abnormal lung tissue from parentage plus the 
common cause — nothing preventing — a progression thai 
would depopulate the earth. 

This, I think, is the exact condition we find in tuber- 
culosis. Tuberculosis is a systemic or constitutional dis- 
ease, due to a common cause, viz., abeyance of atmospheric 
influence. A tuberculous parent transmits a tuberculous 
tissue. A child of a tuberculous parent is prone to tuber- 
culosis. Placed in a condition of enforced suspension of 
atmospheric influence he will assuredly die of tuberculosis ; 
placed in an opposite condition, he probably will die from 
other disease. Tuberculosis has one cause — one alone — 
abeyance of atmospheric influence. 

What evidence have we of this ? The best evidence of 
cognizable facts : The evidence of our senses — intellectual 
perception. 



—108— 

In what does a subject of the tubercular dyscrasia dif- 
fer from the healthy or normal subject? In nothing, so far 
as known ; only in proneness to tuberculosis. The tubercu- 
lar dyscrasia seems a systemic taint that weakens the entire 
human fabric; a poisoned system in which a harmful ele- 
ment is not eliminated ; a system lacking in one essential — 
the oxygen of the atmosphere ; a system that may be re- 
stored to the normal, through the generations by observing 
natural law; a system destined to premature disease and 
death without invoking the aid of this law. 

In the whole realm of disease can an analogous one be 
found? Disease, like facial expression, is similar, yet dis- 
similar. No two faces alike — a similarity in all. Syphilis 
and tuberculosis have many similarities. 

What is abeyance of atmospheric influence? Simply 
suspension of atmospheric* influence, imperfect aeration, 
lack of ventilation of the blood. Can it be made more 
plain? This may arise from causes external or internal, or 
combined. The air we breathe contains certain essential 
elements in relative proportion. This is normal air. 
Should one in health breathe air that deviates from this 
standard it would eventually lead to disease. In other 
words, the disease would be induced by suspension of atmos- 
pheric influence. This suspension does not take place from 
external causes alone. Should one with abnormal lung 
tissue breathe normal air, the blood at the same time not 
being perfectly oxygenated, it would be just as truly an 
abeyance of atmospheric influence as in the former case. 
The result would be the same, though the conditions be 
changed. We have, then, abeyance of atmospheric influ- 
ence from external and internal causes. 

Now suppose, further — and this supposition is not an 
imaginary one — that the two conditions be found at the 
same time in the same individual, viz., abnormal lung tissue 
and abnormal atmosphere. What would result? Disease 
doubly certain, and that, it may be, in the absence of the 
bacillus. This disease would then be induced by combined 



—109— 

causes. In the opinion of the writer, the major part of tub- 
erculosis is so induced. 

Let us now consider severally some of the so-called 
predisposing causes of tuberculosis. It will be seen that 
whatever the ultimate result, abeyance of atmospheric in- 
fluence explains the primary condition. By primary condi- 
tion is meant the state of the patient before the entrance of 
bacilli. 



CONGENITAL DEFECT. 

Children are brought into this world by the vicious, 
over-worked, etc., without object or aim. They are cast 
upon society as helpless waifs, a burden to mankind. It 
were better had they never been born. Without particular 
disease, they fall an easy prey to any. This is the congen- 
ital predisposition of some writers. It is seen where num- 
erous children are born of the same mother in rapid succes- 
sion. The parents may be healthy, but the peroid of rest 
is so short the children do not receive a requisite vitality. 
Children of this stamp readily succumb to any endemic or 
epidemic disease. Is it a wonder multitudes of these chil- 
dren die of tuberculosis ? Would it not be a greater marvel 
that any lived with so unfavorable a birth and environment ? 
Puny in development, with narrow and contracted chest 
walls, the air space for perfect breathing is not sufficient. 
Born perhaps of scrofulous or tuberculous parentage, the 
lung tissue is abnormal, and, as shown, there must be a 
consequent abeyance of atmospheric influence. Add to this 
an unfavorable environment, meaning by this absence of 
proper care, sunlight, clothing, etc. ; add still further, an 
impure atmosphere, and you have a condition favorable to 
the entrance of bacilli. Do the bacilli cause the disease? 
By no means. They simply enter the tissue as a feeding 
ground. As the vulture and dead animal are found together, 
so likewise the bacilli and diseased tissue. It is the condi- 
tion of the system that allows the bacilli to enter. 



—110— 

HEREDITY. 

So much has already been written on this topic that it 
seems superfluous to write further. This much is certain : 
Parentage in the race of life does tell. The nearer perfect 
the health and environment of the parents the nearer per- 
fect the child at birth. The greater the deviation from the 
normal in parentage the greater the deviation from the nor- 
mal in offspring. When writers tell us all are born alike, 
and that the differences in mankind are wholly due to bent 
of inclination, environment, etc., it seems the sanity of the 
writer should be called in question. To think the child of 
the debauche an equal competitor with the child of the up- 
right is contrary to reason and common sense. 

OCCUPATION. 

Another predisposing cause of tuberculosis is found in 
the vocation of the individual. In those trades or callings 
where the rooms are crowded or where the air space is not 
sufficient, the death-rate from tuberculosis is sensibly in- 
creased. Here it is abeyance of atmospheric influence from 
without — impure air. In those trades in which the air is 
filled with an irritant dust, which comes in contact continu- 
ally with the air cells of the lungs, the death-rate from 
tuberculosis is largely increased. Here it is abeyance of 
atmospheric influence from within, due to the irritant in the 
air. The lung tissue actually becomes thickened and dis- 
eased before the bacilli are found. Change of occupation 
frequently effects a cure. Again, we sometimes see the two 
conditions combined, viz., insufficient air space and an irri- 
tant dust. In these cases the death-rate from tuberculosis 
is still higher. Here we have abeyance of atmospheric in- 
fluence from combined causes — lack of air space and the irri- 
tant dust. Suppose the person so exposed be a subject of 
congenital defect, or the tubercular dyscrasia. We would 
then have the maximum death-rate from tuberculosis. In 
all cases it is a suspension of atmospheric influence in the 



—Ill- 
primary condition. Thus in an enumeration of disease in 
which tuberculosis seems to invade secondarily, it will be 
found abeyance of atmospheric influence is always present. 

To summarize: The requisites of perfect aeration are 
normal lung tissue, correlation of force, and a pure atmos- 
phere. The predisposing causes of tuberculosis are : Con- 
genital defect, heredity and occupation. The primary 
cause of tuberculosis is abeyance of atmospheric influence, 
induced by external, internal and combined causes. 

It is seen that tubercle bacilli perform a secondary role 
in the great tragedy of tuberculosis. This is the convic- 
tion of the writer, after years of careful research and 
observation. 



—112— 



ANNOTATIONS. 



"The tubercle bacillus not being inherited, but passing 
into the body from the outside, how does it get there? 
Under what conditions does it exist there? Under what 
conditions does it pass from the outside to the inside of the 
body? Under what conditions does i tlive and proppagate 
there? It is impossible to demarcate the answers to these 
questions as clearly as the questions themselves." — (Jas. B. 
Russell, B. A., M. D., LL. D., Senior Medical Officer of 
Health, Glasgow. Republished by permission by the State 
Board of Health of Massachusetts, 1896.) 

As seen in the preface of the pamphlet from which this 
extract is taken, "The subject is so clearly expressed and 
so admirably treated that the State Board of Health, with 
the consent of the author, has decided to reprint the prin- 
cipal portion for popular distribution." 

We have, then, an eminent health officer writing on a 
subject which concerns us all, and asking under what con- 
ditions the tubercle bacilli enter the system and propagate 
or grow. At the same time he positively affirms no answer 
can be made as clear as the question itself. The writer 
thinks differently. 

The scholiast recognizes five methods of obtaining in- 
formation, viz., observation, reading, listening, conversa- 
tion, meditation. Suffering has also been added. We 
briefly call attention to two or three of these methods. 

(a) Observation. Cast your eye over the field of ani- 
mate nature. Observe closely they who have tuberculosis 
and they who have it not. All belong to one of two classes, 
there is no middle state. Observe the manner of life of 
these distinct classes. No nomad, no wild animal has the 
disease. Among the civilized and the domestic animals the 
disease is found in every case. 



—113— 

Note yet further. All civilized people and all domestic 
animals do not alike have the disease. Some take it while 
others escape. Why do not all take the disease? Why do 
any escape? Observation again points the way. None 
have tuberculosis except they in some way have suspension 
of atmospheric influence. No suspension, no tuberculosis. 
To apply this truth clearly it is observed there is more than 
one way in which suspension of atmospheric influence takes 
place. They who think suspension means simply breath- 
ing an atmosphere in which there is less oxygen than nor- 
mal have only a superficial view of the situation. Suspen- 
sion means more than this. We use in brief a chart as 
heretofore published : 

f Impure f 111 ventilation, vocation, 

atmosphere j etc. 
From without i Impoverishe( f Overheating rooms, im- 

atmosphere ^ proper ventilation, etc. 
I 

Defective Original j Heredity. 

From within { lung- tissue i . . , f Disease, 

fe Acquired { 

^ I ex P osure > e tc 

Observe the monkeys in the forest. Tuberculosis is 
unknown among them. Place these monkeys in confine- 
ment and suspend atmospheric influence in one of the many 
ways, they die of tuberculosis. Avoid the suspension, the 
monkeys live. Observation affords a lesson. 

In " Boots and Saddles," when Mrs. General Custer 
sees, in the great Northwest, the cabin and tepee side by 
side — the one unoccupied — and asks the reason, the igno- 
rant Sioux expresses a truth for all time: " I have a cough 
when living in the cabin." The Sioux knows nothing of 
germs, but he does know the cause of the cough and avoids 
it. Did he know the virtue of ventilation he could live in 
the cabin as tepee. The civilized man knows of the germ, 
but regards nothing else and dies of the cough. Which is 
the wiser? Civilization has many lessons yet to learn. 
One lesson may be learned of the untutored savage. None 
is more important. Will he learn it? 



—114— 

To speak clearly, there is a condition of system which 
allows the entrance of the germ. This condition is pro- 
duced by suspension, which is caused in many ways as 
enumerated. In this there can be no mistake. When Dr. 
Russell declares it is impossible to demarcate the answer as 
clearly as the question, he is mistaken. The mistake can 
be shown by putting a test question, i. e., by taking a 
healthy animal and causing suspension — the germ at once 
takes root and grozi's. This test may be made in the many 
ways of suspension. In this test the law of tuberculosis is 
verified. This law is founded in fact. Of this truth the 
writer is so assured he challenges controversy. 

Why is the Indian in the ill-ventilated cabin subject to 
cough, while the Indian in the tepee is immune? The rea- 
son is simple. It is the condition of the Indian that allows 
the bacilli to enter. This condition is produced, in his 
case, by ill ventilation. Nothing is more certain. Could 
it be otherwise? 

In the writer's judgment there is no question but that 
the advent of civilization was the advent of tuberculosis. 
Must we then go back to nomadic life in order to rid our- 
selves of this dreadful scourge? By no means. All that is 
necessary is to recognize the cause of the disease and remove 
it. Nothing further is required. 

(b) Reading. " When the bacillus obtains access to 
the body of a warm-blooded animal, which it almost solely 
does by the great main entrance, the mouth, passing thence 
into one or other of the diverging channels, the windpipe 
and the gullet, it is not yet in a physiological sense inside 
the body. It must break through the mucous surfaces of 
these passages. This is a most important stage in the ca- 
reer of the bacillus from a preventive aspect," etc. (Dr. 
Jas. B. Russell.) 

When a fire on the hearth or in the furnace is kept 
within its metes and bounds and its gentle warmth is dif- 
fused to every part of the house there is no danger from 
conflagration. The house is not yet on fire. The fire 
must break through the roof and windows of the building. 



—115— 

This is a most important stage in the career of the fire from 
a preventive aspect, etc. There is a close analog} 7 between 
the bacillus and the fire. The bacillus in the windpipe or 
stomach is as fire on the hearth or in the furnace. So 
long as either remain there, no danger is experienced. 
When either leave, the one to grow, the other to consume, 
each becomes an element of danger. Neither can be dan- 
gerous so long as the machinery is intact. The writer thinks 
it becomes the good tenant in either case to attend to all 
needful repairs. Herein he thinks the bacteriologist is at 
fault. 

The writer desires to be honest when he asserts that 
all the bacteriologist attempts to prevent is the entrance of 
the living germ into the healthy system. This is laudatory, 
but unnecessary. Living germs do not enter the healthy 
system to harm or destroy. It is the unhealthy system alone 
they harm. When a system becomes unhealthy from sus- 
pension then the so-called germ enters and propagates or 
grows. 

The bacteriologist asserts, no germ, no tuberculosis. 
The germ is wholly at fault. The writer says not so. There 
is another fault which can be prevented, and in this way the 
disease can be controlled. The fire is not at fault. The fault 
is in a defective flue or fire-box. So, the writer believes, 
the bacillus is not at fault. The fault lies in the defective 
organism in which the bacillus thrives. As stated, this de- 
fective organism is induced by suspension. This may be 
shown at any time, by direct experiment. Why not make 
it? 

It seems our present knowledge is inaccurate or at fault. 
The tubercle bacillus is spoken of as a parasite. It is a 
parasite only in the sense that it propagates or grows in dis- 
eased tissue. A true parasite attacks or attaches itself equal- 
ly well to the healthy or diseased organism. Not so the tu- 
bercle bacillus. To examine more closely the latter part of 
Rr. Russell's statement — "This is a most important stage 
in the career of the bacillus from a preventive aspect." 

Two constructions may be placed on the above. Or, 



—116— 

perhaps, better, the above may be considered from two 
standpoints : 

1. It is truly an important stage. It is the com- 
mencement of the second stage of tuberculosis, and if the 
disease be not controlled at this point in all probability it 
will not be controlled at all. Certainly this is very im- 
portant. 

2. In another sense it is not so important as may 
seem on first sight. The patient has been ailing for weeks 
or months. The bacillus is now about to enter his system 
and grow. Why wait these weeks or months? Why not 
prevent the disease during this long period ? — Why wait un- 
til the last moment? Suppose the firemen of your village 
or city should hear the alarm of fire. Would you have them 
wait until the flame bursts from the roof and windows be- 
fore attempting to extinguish the same? Would it not be 
better to stop the fire at the earliest moment? Why not 
apply this truth to tuberculosis ? 

Physicians are- called poor collectors. Certain it is 
many die in poverty after years of toil. Is not some- 
thing else lacking? Do not physicians lack common sense 
in the application of truth ? The writer is inclined to think 
so. If our reading is to be of avail in the betterment of 
mankind, we must examine and digest what we read and 
truly make it a part of ourselves. Without this we are the 
mere puppets of erudition, nothing more. 

(c) Meditation. "The bacillus is not inherited. As 
regards pulmonary consumption, this statement may be 
taken as absolutely true. The bacillus may pass from a 
tuberculous parent into the body of the fetus, and be born 
with it; and thus the offspring may carry into independent 
life a tuberculous process, but this fact has merely an aca- 
demic interest. Tuberculosis has been actually seen in the 
fetus with just sufficient frequency and certainty to prove 
that the inheritance of the bacillus is not impossible. For 
all practical purposes, the hygienic administrator is bound 
to regard every case of tuberculosis as caused by infection, 



—117— 

which has taken place, so to speak, in the open, within the 
sphere of his control." (Dr. Jas. B. Russell.) 

He who observes must ponder or meditate, else his ob- 
servations will be common as of the multitude. Apples had 
fallen since the days of Adam, but it was Newton alone who 
discovered the law of gravitation. He simply thought 
about the falling apple. He who reads must digest or 
assimilate, or his reading is of little avail. 

The fact that a tubercle bacillus may pass from a tuber- 
culous parent into the body of the fetus truly has academic 
interest. The truth that tuberculosis or the growing bacillus 
is actually found in the fetus is of greater interest and has 
wider range of application. One can readily conceive of a 
plant organism passing into the blood current of the mother 
and thence to the fetus. The finding of a growing bacillus 
in the same fetus is of wider significance. It is a thought 
worthy of our closest attention. It is proof positive a soil 
preceded the growing plant. How came that soil? The 
hygienic administrator sees nothing in this. "He is bound 
to regard every case of tuberculosis caused by infection." 
This statement seems truly marvelous in the light of facts : 
(1) No germ takes root in health; (2) in every case a soil 
precedes the growing plant; (3) the tuberculous parent 
transmits a soil. It is seen : No infection can take place 
unless there be a suitable soil. But the tuberculous 
parent transmits a soil, hence the hygienic administrator is 
bound to regard every child of tuberculous parentage. 
Yet more, he is bound to regard every tuberculous marriage. 
When we consider a soil is produced in one way, and must 
in every case precede the growing germ, it is high time the 
hygienic administrator recognizes this fact and acts accord- 
ingly. No such recognition or action will be taken so long 
as he firmly believes the germ theory of tuberculosis. Let 
us at once and forever discard this theory. Mankind will 
receive a marked benefit. 



-118- 



DUTIES OF THE HOUR. 



To see ordinary duties postponed from time to time 
when they should be discharged at the moment is a sad 
commentary on human life, but such is seen at man's best 
estate. " Procrastination is the thief of time." A worse 
condition is often observed : Urgent work is neglected and 
the time occupied with things of a trivial nature. 

This procrastination or putting off the essentials while 
superficialities engage the attention is a common fault and is 
due to many causes. Foremost among them is a lack of 
thought. The child at school who idles away the time 
instead of getting the lesson is doing this very thing — a lack 
of thought. In after years the thoughts come thick and 
fast when there is little time for reparation. So in man- 
hood we aften take up those subjects which are truly least 
beneficial, and find in old age we have wasted our time and 
substance for naught. 

The medical man is subject to the same fault and gives 
way to the same weakness. How often we observe the 
carefulness of procedure in seeking out a so-called germ, in 
establishing its habitat and means of propagation, and then 
giving way to a childish method of disease communication 
and suppression. 

In no disease is this seen more clearly than in tuber- 
culosis. By erudition and a pains-taking accuracy it is 
determined that a plant or bacillus is found in certain con- 
ditions of the system, that in these conditions a disease is 
commonly present, known as tuberculosis. Without fur- 
ther care or thought it is at once assumed the disease con- 
dition is caused by the plant or so-called germ. Nothing is 
more foolish. A plant growing in a certain condition is no 
evidence the plant causes the condition named. It simply 
shows a live plant has found a favorable soil. This favor- 
able soil may be found or determined in two ways : (1) Nat- 
ural selection or affinity; (2) transference. 



—119— 

Illustration : Mr. A plows a field and weeds spring up 
in every direction — natural affinity. It may be one or more 
particular kind of weeds are found growing. Mr. B plows 
a field and sows one or more kind of grain. A transference 
is here seen. In the two cases the soil is similar, the sow- 
ing dissimilar, the fruitage or growth is like or unlike. 
The distinction is in the method in which the plant or seed 
becomes rooted in the soil, i. e., natural or artificial. In 
other words, the distinction is the way in which tuberculosis 
becomes seated in the system. The soil is alike in botli 
cases. 

On this and on this alone hinge the worth or littleness 
of our knowledge in tuberculosis. On this and on this 
alone must be estimated the merit of infection or contagion. 
Is tuberculosis infectious or contagious? Is the soil favor- 
able? Weeds or seed do not grow unless the soil be favor- 
able ; neither do germs. 

Disease extension in tuberculosis is seen on every hand. 
Why? Its cause is wrongly interpreted. Disease suppres- 
sion is nowhere to be seen, or at best only in isolated cases. 
Why? Present methods are utterly insignificant. First 
grasp the true cause of tuberculosis, then act, not talk of 
disease suppression. 

It may be asked, is not tuberculosis less prevalent now 
than it was a few decades ago? The disease seems less 
prevalent, but this is due not to our greater knowledge of 
germs and avoidance of them, but rather to a better method 
of living, in that we have more commodious dwellings, 
take more exercise in the open air, etc., etc. Advance fur- 
ther in this direction and the condition of the people will be 
yet more marked. 

Our knowledge of germs has done little if anything 
per se in combating the ravages of this disease. That this 
statement is true every acute observer will plainly recognize. 
We see a natural and a selective affinity in the daily voca- 
tions of life. 

Milk, on standing in the open, becomes acid or sour. 
We are told this is due to the presence of germs. Please 



—120— 

observe : Conditions of the atmosphere hasten the changes 
that occur. May it not be that the condition of the atmos- 
phere prepares a suitable soil? Is this not probable? 
Must it not be so? If not, why should milk turn quicker in 
some atmospheres than in others ? 

If the milk be hermetically sealed no change takes 
place. Science tells us this is due to the exclusion of germs. 
Gertain it is, the milk thus sealed is not subject to the 
atmospheric conditions. It is seen there are two ways to 
prevent the changing of milk: (1) Select the atmosphere; 
(2) hermetically seal. The first is difficult. The second is 
readily performed. Hence the sensible farmer or dealer in 
milk adopts the second. 

Take the lesson we learn from the action of milk and 
apply to the human system. 

In our daily rounds we meet multitudes of people who 
have, in one form or another, the disease known as tuber- 
culosis. Some have placed the proportion among the civ- 
ilized as large as three-fourths of the entire number of peo- 
ple. The writer thinks this an exaggeration, but it will be 
admitted that the exact number who have the disease, 
though large, is hard to estimate. 

Present science says the disease is caused by a germ, 
known as the tubercle bacillus. The writer denies this, but 
admits that in many cases of the disease this germ is found 
growing ; in other cases the germ has not taken root. The 
disease may be in an incipient state, and all that is lacking 
is a favorable soil. So soon as the soil be favorable so soon 
is found the growing germ. A person in this condition 
may be compared to milk standing in the open. If the 
atmospheric conditions be favorable the milk turns sour, or 
the germ takes root. In the individual the growing bacillus 
is added to the already serious disease. The ailment then 
takes upon itself a two-fold nature, viz., the prepared soil 
and the grozving plant. Herein the germ theorist is sadly 
at fault. He regards not the dual nature of the disease, 
and directs his energies to. the germ alone. 

The writer believes the average germ theorist to be 



—121— 

germ proficient and common sense deficient. Knowledge is 
power, but common sense should be used in its application. 

It will be remembered there are two ways to prevent 
the change in milk. There are also two ways to preven: 
the germ's entrance and growth in the system. To her- 
metically seal the milk works admirably. Could we hermet- 
ically seal all avenues of entrance of animal life no doubt it 
would work equally well, so far as the germ's growth is 
concerned, but this cannot be done. Neither can we prac- 
tically build germ-proof houses in which to live. One 
alternative yet remains. We can control the soil in which 
the germ thrives. In other words, we can control the 
atmospheric conditions which cause the favorable soil and 
thereby control the disease. This is certainly worth know- 
ing. Its attention is a duty of the hour, an essential which 
should be regarded at once. Knowledge of this truth 
makes it reprehensible in us if we do not take heed to its 
teachings. 

What is one of the superficialities? The tweedledum 
and tweedledee of germ infection and immunity. Immunity 
is a myth, infection an impossibility with an unfavorable 
soil. He who allows or causes a soil to become favorable 
should be held criminal before the lazv. 

This may seem serious talk, but in so insidious and 
deadly a disease as tuberculosis there should be no> white- 
wash or red tape. All teaching should be plain common 
sense. 

An elective or selective affinity is seen by the good 
housewife in making bread. Yeast is prepared and at a 
proper stage of the proceeding is transferred and thoroughly 
mixed with the flour dough. The ferment causes the dough 
to rise, and in this way the enlarged or aerated loaf is ob- 
tained. This measure is one of convenience. The dough 
would naturally ferment or rise if the atmosphere condi- 
tions be favorable, but the action would be slow, erratic or 
irregular — hence the artificial transfer. What is the dough 
at best? Only a favorable soil. What is the yeast? Mul- 
titudes of growing germs. The germs placed in a favora- 



—122— 

ble soil at once take root. 

Here is a lesson in bacteriology. Certain cultures are 
procured in a similar way. Starch solution or beef bouillon 
is used as a media and germs are propagated in these. 
Now because cultures may be obtained to the fourth or fifth 
generation is no evidence the culture causes the media. 
The media is procured. The germ is procured. They are 
simply placed in continuity under favorable conditions, and 
the one affords nourishment to the other. The germs de- 
velop or grow. This is a simple but truthful explanation. 

It is marvelous to what straits the germ theorist is 
reduced in talking of these things. According to him the 
germ is all in all. It is no such thing. The germ is only 
one factor, the media another, and the conditions a third. 
The one who rationally talks of tuberculosis must bring in 
three factors : Media, condition and germ. If he talk of 
germ alone he is one of the foolish virgins, and will soon 
borrow oil or be left in darkness. The present age is one of 
advance. Let us march forward. Tuberculosis can be con- 
trolled and the world should know it. Did I say can be? 
It is controlled and the world should know the way. The 
author endeavors to give it ; accept in this spirit. 

We see an illustration of selective or elective affinity 
in the experiments made in the bacteriological laboratory. 
Cultures as above made in beef bouillon are transferred to 
the animal kingdom, as the guinea-pig, dove or rabbit. 
Upon inoculation with these cultures it is found, generally 
speaking, that they continue to grow and the animal dies of 
a disease similar or like the one from which the original 
germ was taken. This is assumed as proof positive that the 
germ so found is the cause of the disease. Let us not be 
too hasty in our conclusions. Assumption in every case is 
not found to be truth. 

We stated three conditions are necessary in order to 
have the transfer or artificial removal a success, viz., media, 
condition and germ. The germ selected is, of course, a live 
or proper one. The condition is of the live animal, warm 
and moist, the most suitable. The media must afford noui- 



—123— 

ishment, else the plant would not thrive. What more do vvc 
wish? What does the experiment prove? Simply that 
plant growth will thrive in the live animal, or under vary- 
ing circumstances. Does it prove that the germ causes the 
disease? By no means. In the first place, live animals, in 
their normal condition, in the open air, never nave germs 
growing in their system. The placing of them there is an 
artificiality. If naturally, in health, they do not enter the 
system and grow, how can we establish that the artificial 
insertion is the natural cause of the disease? Such reason- 
ing is unworthy the school boy. Yet such reasoning passes 
for science. 

A short time since the writer was invited by his friend, 
Dr. Dudley P. Allen, to walk through the various apart- 
ments of the Lakeside Hospital, Cleveland, O. Among 
others he pointed out the rooms for microscopical and bac- 
teriological experiments. I saw in little crates or cages, 
doves, rabbits, guinea-pigs, etc., and thought in passing, 
here is an artificial condition for natural entrance of germs. 
The transfer made in the laboratory, like the transfer made 
by the good housewife, is an artificial one for convenience. 
It is more speedy. But in either case it proves nothing ex- 
cept germs thrive and propagate in a variety of media. 
When will we learn wisdom? Certainly we ha\^ not as yet. 

For a natural entrance of growing germs there must be 
a prepared soil. Whether we prepare the soil ignorantly or 
wisely, the germ alike takes root and grows. If we prevent 
the formation of soil, we prevent the growth. Here is the 
true secret of all tubercular disease. 

Tuberculosis is a disease of civilization caused by sus- 
pension of atmospheric influence, in that the suspension 
prepares the soil for vegetable growth. 

The disease is governed by the following law : The 
death-rate from tuberculosis is in direct ratio to suspension 
of atmospheric influence. 

What, then, are the duties of the hour? To prevent 
suspension in every conceivable way. 



—124— 



A CATECHISM. 



What is tuberculosis? A constitutional disease depen- 
dent largely on the evils of civilization, and governed by 
the following law : The death-rate from tuberculosis is in 
direct ratio to suspension of atmospheric influence. 

Do not standard medical writings tell us tuberculosis is 
caused by the germ tubercle bacillus? Yes, they so in- 
form us. 

Is not the consensus of medical opinion, as found in 
those writings more likely to be correct and of consequent 
greater worth than individual opinion? Yes, this is true as 
a general proposition. 

Why, then, should one persist in saying tuberculosis is 
caused by suspension of atmospheric influence. Every one 
as a witness should tell "the truth, the whole truth and 
nothing but the truth." 

We are witnesses. As such, must we agree with the 
multitude or tell that we know? The upright judge 
would say, "Tell that yon know." Again, no body of men 
is infallible. Because the multitude say a statement is cor- 
rect is no reason it is so. 

Is not the presence or absence of tubercle bacilli in the 
tissue an evidence of the presence or absence of tuberculosis ? 
Listen to an authority : "The tubercle bacillus is ubiquitous/' 

Is not a growing bacillus in one's system an evidence 
of tuberculosis? Yes, but the growing bacillus implies a 
precedent state. Without this state the bacillus does not 
grow. The tubercle bacillus is not found growing in the 
healthy system. 

The question now arises, which is the primary cause of 
tuberculosis, the precedent state — suspension — or the tuber- 
cle bacillus? Look around you! What takes prece- 
dence, the growing plant or the soil in which it grows. 
In every case, the soil. 



—125— 

Which is, then, the primary cause of tuberculosis? 
One answer : The soil — the precedent state — or suspension 
of atmospheric influence. 

Having determined the primary cause of tuberculosis, 
let us now proceed. 

Mr. A has tuberculosis. Mr. B has the precedent 
state. Will the writer please tell us the difference in these 
cases? Mr. A has the precedent state plus the growing 
tubercle bacillus ; Mr. B has the precedent state. Messrs. 
A and B each have tuberculosis. 

Tuberculosis may exist in the absence of tubercle 
bacilli, but can never exist without the precedent state. 
Herein lies the error of the savant Koch. He has mis- 
taken the cause of tuberculosis. His attention has been 
directed alone to the germ tubercle bacillus. 

Tuberculosis is not caused by the tubercle bacillus. It 
is due to suspension of atmospheric influence, is based on 
law and can be controlled. 

To be clearly understood, the writer makes tuberculosis 
more comprehensive. The term includes : 

1. All cases in which the growing bacilli are found. 

2. All cases in which the condition of the system is 
such as to allow the tubercle bacilli to take root. Should 
we classify: 

First stage, prior to entrance of bacilli — subject to 
control. 

Second stage, after entrance of bacilli — amenable to 
treatment. 

Third stage, breaking down of tissue — treatment of 
little avail. 

Having shown the plant growth is a secondary condi- 
tion or modifying influence in this most fatal disease, we 
would now call attention to modern treatment as directed 
against this growth or supposed cause. We do this the 
more willingly feeling assured this treatment must ever be 
barren of permanent curative results, and at times danger- 
ous to the patient. 

What is tuberculin? As first given the public, tuber- 



— 12G— 

culin is a glycerine extract of tubercle bacilli cultures. 

Judging from observation, of what use is tuberculin? 
Largely commercial. 

Has tuberculin value ? Yes. Illustration : Mr. A has 
tuberculosis, as ordinarily defined, i. e., the precedent state 
plus growing tubercle bacilli. Here it has value. That 
there be no mistake in this matter, we quote no less an 
authority than Prof. Jas. T. Whittaker : " The value of 
tuberculin in the diagnosis of the disease in cattle is univer- 
sally accepted. According to the report of Salmon, thus 
far we have yet to meet the first case which reacted and did 
not show tuberculosis upon post mortem examination." — 
Lancet-Clinic, Sept. 11, 1897, *. e., tuberculosis as ordi- 
narily defined. 

(a) Tuberculin determines the presence of growing 
bacilli. 

Today, as then, these words are true. All tuberculin 
determines is the presence of growing tubercle bacilli. 
Hundreds of cattle stand in their stalls with the precedent 
state. Thousands may likewise stand in favorable condi- 
tions to produce this state. Of these tuberculin says 
nothing. 

This leads to another question, has tuberculin value in 
diagnosis ? No. Illustration : Mr. B has the precedent 
state, i. e., tuberculosis as defined by the writer — no grow- 
ing bacilli induced by suspension of atmospheric influence. 
(Please observe Mr. B has the symptoms of tuberculosis as 
found in the first stage of the disease.) 

An injection of tuberculin is made; no reaction. What 
does this injection determine? 

(b) Tuberculin has no value in diagnosis. 

But if there be stages in the disease tuberculosis, the 
first designated by absence, the second by presence of grow- 
ing tubercle bacilli ; if tuberculin determine the presence or 
absence of these, is not the extract useful? 

When the writer remembers the first stage is subject to 
control, the second simply amenable to treatment, this fact 
appears valuable should we possess an accurate means of 



—127— 

determination. It is known to every practitioner that tub- 
erculosis in its first stage is difficult to detect. The stage 
being determined, the physician knows for a certainty the 
result to expect from treatment — a very valuable acquisition. 

Can we with certainty differentiate the first stage by 
means of tuberculin ? No. Illustration : Mr. C is sick and 
calls on his physician. The symptoms simulate malaria. 
The blood is examined ; no plasmodium found. A tenta- 
tive injection of tuberculin is made; no reaction. What 
does this determine? The absence of growing bacilli. 

It has been shown that growing bacilli are absent in 
health. They are absent in many diseases. The mere ab- 
sence of growing bacilli does not determine the first stage 
of tuberculosis ; therefore : 

(c) Tuberculin has no certain value in differentia- 
tion of first stage. 

Is the use of tuberculin dangerous? Yes and no. 
Illustration : Mr. D is ailing. He has symptoms of incip- 
ient tuberculosis, or the precedent state. He has reason to 
fear tuberculosis in the first stage, for his occupation and 
manner of life are such as to induce this state. He asks his 
physician, who is a noted bacteriologist, if there be any way 
to determine whether he has tuberculosis or not. The doc- 
tor replies " The science of medicine has made rapid ad- 
vances. When you were a boy this could not be deter- 
mined. Now it is as simple as A, B, C. Dr. Koch de- 
serves the gratitude of mankind." An injection of tubercu- 
lin is made ; no reaction. The patient is assured : " Your 
fears are groundless; no tuberculosis whatever." (It must 
be remembered the precedent state is the condition of the 
system in which the living tubercle bacillus takes root.) 

What is the actual result? Mr. D passes rapidly from 
the first to the second stage of tuberculosis — from a curable 
to an incurable condition. 

What is the actual results ? Mistaken diagnosis, loss of 
confidence in the physician, death of the patient. 

(d) Tuberculin is sometimes dangerous. 

True, the patient is dead. Can it be shown tuberculin 



—128— 

is the cause of death? Has not Prof. Whittaker told us he 
has used tuberculin every day in hospital and private prac- 
tice for six years, in now nearly one thousand cases, and has 
never seen any kind of evil result? Does not Prof. Koch 
say in substance that tuberculin is perfectly innocuous? 
Why decry tuberculin ? 

That there be no misrepresentation we quote from the 
published writings of Koch, as translated by J. T. W. 
(Lancet-Clinic, April 24, 1897) : "Only the most extremely 
virulent cultures should be used in the preparation of TR 
. . . They must be prepared as fresh as possible . . 
. . . I consider it out of the question to produce TR in 
large quantities with the hands .... At my sugges- 
tion, apparatus for wholesale manufacture has been pro- 
vided." 

Listen to what follows concerning Prof. Koch's new 
tuberculin : " In regard to TR, it has been subjected to 
much criticism, both on account of the failure in some hands 
to obtain hoped-for results, and on account of the impurity 
of some of the samples that have been sent out by the firm 
that have been allowed by Koch to manufacture this prod- 
uct for the market." Again : "According to Trudeau and 
Baldwin, some tuberculosis bacilli may be found in the 
preparation." (Bulletin of the Pasteur Institute, July, 
August and September.) 

After reading the above it seems further comment is 
unnecessary. 

Is tuberculin dangerous? No, if perfectly pure and 
injected with proper precautions. 

To summarize: The injection of tuberculin determines 
the presence or absence of growing bacilli, is of no value in 
diagnosis of tuberculosis, of uncertain value in differentia- 
tion of first stage of the disease, and is sometimes dangerous. 

It is seen from the above that the intrinsic value of 
tuberculin is small, while, under existing circumstances, its 
commercial value may be great. 

What of tuberculin in treatment ? When Prof. Andree 
launched his balloon in search of the pole he began a peril- 



—129— 

ous journey; result unknown. So when one promises cure 
of disease not understood, he is traveling — no one knows 
whither. 

What is a constitutional disease? The word constitu- 
tional is significant. When that prince of cynics, Thomas 
Carlyle, took a walk for the good of his health, he spoke of 
it as a " constitutional " — conveying the idea, as the writer 
thinks, that physical evercise in the open air builds up the 
entire system. 

When one speaks of a constitutional disease he means a 
systematic ailment that primarily is taking away or destroy- 
ing the life or vigor of the entire organism. 

The word constitutional is used in contra-distinction to 
local. Should one in the prime of life gradually decline in 
physical and mental vigor, we properly designate this a 
constitutional disease. Should one have an ailment in one 
part or member of the body, we properly designate this a 
local disease. 

In medicine constitutional and local are relative terms 
used to point out the extent of invasion. If applied to 
treatment they respectively represent the whole or part of 
the system for which the remedies are taken or applied. 

From the very nature of the case, when one has a con- 
stitutional disease he frequently has local symptoms. Per 
contra when one has local disease he frequently has con- 
stitutional symptoms. 

Our system is so connected and complex, one part be- 
ing dependent on another, that when one member is dis- 
eased the entire system suffers ; when the system is diseased 
individual members suffer in a greater or less degree. 

These remarks may seem common-place. They are 
common language used to make plain the nature of a con- 
stitutional disease. 

The writer takes it, a constitutional disease is a disease 
of the entire organism, and that primarily. 

Is tuberculosis a constitutional disease? On this, as 
many other subjects, writers fail to be lucid. If we attri- 
bute the diseased condition found in tuberculosis to the 



—130— 

action of the germ tubercle bacillus alone, as is the common 
sentiment of the medical profession today ; if the tubercle 
bacillus capture and kill its subjects, as a fox a lamb in the 
open, tuberculosis may be regarded a local or infectious 
disease. The writer is unwilling to accord so potent an in- 
fluence to the plant. 

We are told one takes tuberculosis as he takes measles, 
etc. The inception of tuberculosis is a question of expos- 
ure. As the majority of mankind have measles at some 
period of their existence, so the majority have tuberculosis. 
As some do not " catch " measles, so some do not " take " 
tuberculosis. This seems very simple. . 

Is this view strictly correct? Let us examine this sub- 
ject a little more closely. The tubercle bacillus is a plant 
growth. Like all vegetable organisms, the plant must have 
a soil in which to develop. True, the soil for the vegetable 
growth is found in a living animal, but please observe the 
soil per se is a dead or partially disorganized tissue. Must 
it not, of necessity, be so? 

Science tells us that plant life can assimilate only the 
simplest forms of food; that tissue of the living animal is 
food not in its simplest form. Therefore, the living tuber- 
cle bacillus per se cannot take root in the living animal. 
Hence, a soil must be prepared before the reception of its 
host. 

For an. author to state that tuberculosis is caused by a 
germ, and is received in the same way as measles, etc., is, 
to say the least, an expression of ideas with little reflec- 
tion. The method of infection in measles and tuberculosis 
is very different. Is it necessary to prepare a* soil for the 
inception of measles ? Can we in any way so prepare a soil ? 
Is a soil prepared in every case of tuberculosis before the 
bacilli can take root? Yes, in every case. Can we so pre- 
pare a soil? That we can must be evident to every ob- 
server. 

Illustration : Take a number of monkeys from the for- 
est. In their natural state tuberculosis is unknown among 
them. Place these monkeys in confinement, with poor ven- 



—131— 

tilation, for a few days. It will be found that not some but 
all have the precedent state or soil necessary for the growth 
of tubercle bacilli. It will be found in a short time that 
not some but all have tuberculosis. 

In an exposure to measles some few escape ; not so in 
tuberculosis, if the soil be prepared. 

It may be asked, does not confinement per se aid in the 
production of the precedent state? This is answered most 
emphatically in the affirmative. 

We have shown suspension may take place from within 
or from without. We have shown that exercise in the open 
air prevents the precedent state. To now speak of confine- 
ment as an aid to the precedent state seems superfluous. 
Confinement or lack of physical exercise must, of necessity, 
be an aid in its production. 

One writer says tuberculosis is a disease of the nervous 
system. He reasons : In every case of tuberculosis the ner- 
vous system is involved. 

Another might say tuberculosis is a disease of the mus- 
cles, for in .every case the muscles are wasted. 

A third might say it is a disease of the osseous system, 
etc., etc. 

The truth lies here: Tuberculosis is not a disease pri- 
marily of any one isolated system, but is a constitutional 
disease. As such it includes everything in the physical 
make-up of the organism. The truth of this assertion can 
be verified by any observer or pathologist. 

Let us for the moment lay aside the idea of germs and 
calmly consider the pathological condition as found. One 
has phthisis pulmonalis — tuberculosis of the lungs ; another, 
tabes mesenterica — tuberculosis of the mesentery ; a third 
receives an injury, an amputation is performed, and tuber- 
culosis develops in a partially healed stump, etc., etc. It is 
seen the pathological condition is found in many organs of 
the body. While one organ — the lung — has a preeminence 
in this regard, yet the fact of finding tubercle in every organ 
would lead one to suppose a constitutional dyscrasia pre- 
ceded the pathological condition. In other words, that tub- 



—132— 

erculosis is a constitutional disease before the formation of 
tubercle. 

Why one organ is predisposed in one individual and 
another in another is perhaps due to an innate weakness of 
that particular organ. 

It is generally found that when tuberculosis of one 
organ causes death, the evidence of the disease is not local, 
but systematic, showing a condition of system preceded the 
local condition. 

But, say some, " How can these things be?" Does not 
the bacteriologist inject tubercle bacilli cultures into the 
healthy living guinea-pig, and do they not grow? Why 
should one say a soil must be prepared ? 

Another question : " Do these bacilli naturally grow in 
the tissue of the healthy living guinea-pig?" Is not the 
method of injection an unnatural method? In seeking nat- 
ural results why not use natural methods? For tubercle 
bacilli to grow in a natural or spontaneous manner a soil 
must be prepared. 

Let every biologist in the land take this truth to his 
laboratory and ponder it in his heart. Let him ponder with 
the slide of his microscope intact. Then will he truly learn 
the science of life. 

What is meant by civilization? 

" An improved condition of man resulting from the 
establishment of social order in place of the individual in- 
dependence and lawlessness of the savage or barbarous life. 
It may exist in various degrees ; it is susceptible of continual 
progress." — (Guizot, translation by Hazlitt.) 

Do we understand civilization has evils ? 

As Guizot has put it, civilization is an improved condi- 
tion. Let no one assume the life of the savage is equal to 
the life of the civilized. A just comparison places savagery 
far in the background. Should any doubt this let him com- 
pare the condition of woman in the two stages of existence. 
In savage life she is the menial of man, subject to his ca- 
price; in civilized life his equal in every regard. Nowhere 
today do we see the savage exalted except perhaps in poet- 



—133— 

ical effusion. 

The author quoted tells us civilization exists in various 
degrees. For example, the civilization of the United States 
in 1897 is not the civilization of Spain for the same year. 
There is an immense difference. 

Again, civilization is susceptible of continual progress. 
No nation or people have, as yet, arrived at an ideal of civ- 
ilization. As the Methodist brother puts it, " We must go 
on unto perfection." 

If civilization be not yet perfect, evils must exist. To 
what particular evils does the writer refer? 

Only to those which cause suspension of atmospheric 
influence, or the precedent state. In other words, only 
those which cause tuberculosis. 

What is one of the most flagrant evils of civilization? 

Ill ventilation : (a) In the home; (b) in the work shop ; 
(c) in the public hall or conveyance. 

(a) The writer's attention was called to the remarks of 
some poor immigrants : " What lovely homes ! Do the peo- 
ple own these? How did they get them? In our country 
no one owns homes except the rich. A sad commentary 
on European civilization. Will it ever be so in America? 
The bulwark of strength in our land today is the home. 
Churches may rise and fall, nations come and go, but the 
home is sacred and should remain. To the home we are at- 
tracted and tied. 

In building the home or temporal structure in which 
we live, mankind is fallible. We build too large or small, 
or not in accord with the laws of nature or of health. We 
build each after his own model or ideal, and our houses dif- 
fer as our judgment. " Each thinks his correct." As mis- 
placed confidence in marriage wrecks the happiness of the 
earthly home, so building ill-contrived or ill-constructed 
houses wrecks the happiness and health of those who in 
them dwell. 

In obstetric practice we are often called into homes in 
which the bedroom or sleeping apartment is the smallest 
room in the house. This is a mistake ; it should be the 



—134— 

largest. In close apartments the air is breathed and re- 
breathed many times during the night. 

In the selection of a furnace or heating apparatus mis- 
takes are made. Furnaces, in general, are too small. The 
furnace should at least be double the capacity required in 
cold weather. There is then no white or red heat of the 
furnace to abstract oxygen. It has been already shown 
that impure or impoverished air causes suspension of at- 
mospheric influence or the precedent state. Herein lies the 
secret of the so-called infectiousness of tuberculosis. 

Tuberculosis is never infectious in a pure atmosphere. 
Tuberculosis is ever infectious in an impure atmosphere. 

What is the lesson taught? , To ever keep the atmos- 
phere pure. 

To summarize : Each resident in America who builds 
a home builds as best suits his judgment. In construction 
little regard is paid to ventilation. This is perfectly natu- 
ral, for present teaching seems to be how to render the 
home germ proof. 

(b) In one sense our work-shop is our home. One is 
an attorney, another a merchant, another an artisan, etc. 
Each is engaged in his vocation a certain number of hours 
per day. For these hours his shop or office is his home. 
The laws of health apply as in the home. The ventilation 
and heating should be on the same principle — an abundant 
supply of pure air. 

To the artisan in his shop there is an element of dust or 
vapor with which he must contend. This increases the 
danger from tuberculosis in that it increases the suspension 
of atmospheric influence from without. 

Who has not observed the increased death-rate from 
tuberculosis in the artisan? Have you ever thought this 
increase was due to excess of germs in the little shop in 
which he works single-handed? In the writer's judgment, 
the increased death-rate is not due to excess of germs, but 
to suspension of atmospheric influence from without. The 
germs then enter. 

In the larger shops there are often three factors at 



—135— 

work at one and the same time: (1) Insufficient air space, 
consequent rebreathing or air impoverishment; (2) poor 
ventilation, to prevent draughts or to keep out the cold — 
therefore, impure air; (3) the irritant dust or suspension 
from without. Add to these, heredity, low vital resistance, 
etc. Is it any wonder multitudes thus placed readily suc- 
cumb to tuberculosis? 

Please look at the question from a rational standpoint. 
Would you think a disease thus caused could be prevented 
or cured by other principles than those of common sense ? 

What would be a teaching of common sense? (1) 
Abundance of pure air; (2) elmination of the irritant dust; 
(3) all workmen with an hereditary taint excused. 

What is present teaching? (1) Artificial immunity — 
injection of tuberculin-; (2) prevention of infection — cuspi- 
dors partially filled with water, into which- all workmen are 
taught to spit. The comparative merit of the two methods 
of prevention is left to an intelligent profession. 

(c) The people who continuously dwell in close houses, 
who assemble in close public halls and churches, are the 
civilized. The people who continuously suffer most from 
the dread disease, tuberculosis, are the civilized. These 
two statements must ever be borne in mind. 

Of civilization and tuberculosis, which precedes the 
other ? 

In one sense there, is no precedence. Where we find 
the one, there we find the other also. Civilization and tu- 
berculosis, like twin sisters, walk hand in hand. In point of 
time there is precedence. 

Civilization has evils. Civilization must exist before 
evils develop. In this sense civilization precedes the evils 
and the disease rapidly follows — cause and effect — the one 
shrouded in the mysticism of the ages, the other plain as 
the noon-day sun. 

Can nothing be done to avert the calamity that has fal-: 
len upon us as a civilized people? 

So long as students in medicine are taught that tuber- 
culosis is due to a germ; that immunity may be secured by 



—136— 

injection of tuberculin, so long there will be no true prog- 
ress in prevention and control of the disease. So soon as 
we grasp the true or primary cause of tuberculosis — suspen- 
sion of atmospheric influence — so soon we take the first step 
in prevention and control. There can be no definite action 
until there is clear apprehension. 

Perhaps no great nation of the earth has better inter- 
communication than the United States. A famine in our 
land would be well nigh an impossibility. One wishes to 
travel; he has only to select his route and trains pass and 
repass by day or night at his very door. It seems perfection. 

Did you ever think of the incoveniences of travel? 
We refer more particularly to the irritant dust or smoke of 
the cars ; of the close and vile air contained in them. Have 
you ever experienced these? The same inconveniences of 
travel are found on many crowded thoroughfares of our 
large cities. Day by day we see every available space 
taken. Standing room is at a premium, for in standing one 
occasionally gets a breath of fresh air as the door is opened. 

To what danger are we exposed in these closed coaches 
and assembly halls ? Suspension of atmospheric influence — 
the precedent state — incipient tuberculosis. 

Does not the danger consist in infection from the germ 
tubercle bacillus? As already stated, infection cannot take 
'place unless one has the precedent state. This state is in- 
duced by suspension, avoided by breathing pure air. 

What, then, is the preventive? 

An abundant supply of pure air. 

The way to cure disease most speedily has long been 
sought in the practice of medicine. Human judgment is 
ever at variance as to method, a clear indication that no 
perfect way has as yet been found. 

One thing the present generation has taught us : The 
necessity of prevention. In this regard no century of his- 
tory can show a brighter record. We are entering the por- 
tals of a millennium. God hasten the illumination. 

Truly, who can cure tuberculosis? No one. Who can 
prevent the disease? Only he who understands its cause. 



—137— 

The study of causal conditions in tuberculosis should there- 
fore be our highest aim. Let us ever keep this thought in 
mind. 

In how many ways is suspension of atmospheric influ- 
ence induced? Suspension may take place from within or 
from without. From without through impure or impov- 
erished atmosphere; from within through defective lung 
tissue, original or acquired. 

When is an atmosphere impure? An atmosphere is 
impure when it contains a mechanical or chemical irritant. 
In grinding on an emery wheel, or in certain vocations in 
stone work, etc., the dust irritates the lungs, or collects on 
the mucous surface, and thereby suspends atmospheric in- 
fluence. The same suspension is found in vocations in 
which the irritant is a gas or vapor, etc. 

When is an atmosphere impoverished? When, from 
over-heating of rooms, improper ventilation, etc., the oxy- 
gen in the air is less than normal. 

How does impoverishel atmosphere produce suspension 
of atmospheric influence? A certain amount of oxygen is 
necessary at each inspiration to properly aerate the blood. 
If oxygen be deficient in the air the respirations must be 
hurried, or else the blood is not aerated. Imperfect aera- 
tion is suspension of atmospheric influence. 

A careful study of the death-rate from tuberculosis will 
show it is largely increased in cases of suspension of atmos- 
pheric influence from without. 

To what extent is the death-rate increased ? In pro- 
portion to suspension of atmospheric influence. Let us see 
if this be true. Here are two men doing like work in the 
same room. One dies of tuberculosis, the other continues 
at his work. Why this marked difference? 

1. Heredity. If heredity and environment be the 
same, like results could be anticipated, not otherwise. 

2. Home life during non-working hours. If the same, 
like results. 

3. Vital resistance. Mankind are not born alike in 
power to endure ; if so, there is inequality in vital resistance. 



—138— 

If heredity, home life and vital resistance be the same, 
we should expect similar results. At the same time, what- 
ever the comparison, it will be found that suspension of at- 
mospheric influence induced the precedent state. Without 
this there could be no tuberculosis. 

What is meant by defective lung tissue? The word 
defective is used in its ordinary sense. If a limb be defec- 
tive it is in some way weakened or deformed; if a fruit or 
growth be defective it is not perfect. So in lung tissue. 
Defective lung tissue is not perfect, does not perform its 
normal functions. The function of lung tissue is to ensure 
perfect aeration of the blood. If this tissue be inflamed or 
thickened it is defective; if it be permanently thickened, or 
if it be of abnormal tissue, its function is weakened or 
destroyed. 

A lung tissue may also be impaired temporarily or per- 
manently. This impairment may be due to heredity or ac- 
quisition. If to heredity, one is responsible for results only 
as to using the one talent aright ; one talent is all that is 
granted. If to acquisition, one is responsible not only for 
the right use of the talent remaining, but also for the loss of 
the many talents bestowed. 

Profit and loss are seen in life as in business. Should 
we recklessly throw away our God-given faculties there is 
no one to blame but ourselves. If we use and strengthen 
those granted us, it is all a reasonable creator could ask or 
creature desire. 

To any who closely study disease it is seen that the off- 
spring of defectives are defective. It is also seen that one 
cannot recklessly throw away a treasure and at the same 
time have it. 

To those who study tuberculosis it is seen that children 
of tuberculous parents are generally tuberculous. It must 
also be seen that there are certain acquired conditions which 
predispose to tuberculosis. In a tuberculous offspring there 
is original defective lung tissue — suspension of atmospheric 
influence, the precedent state. In other cases, as in measles, 
pertussis, etc., there is an acquired defective lung tissue — 



Suspension of 

atmospheric 

influence. 



—139 

suspension of atmospheric influence, the precedent state. 

To recapitulate: The precedent state or incipient tu- 
berculosis is caused by suspension of atmospheric influence. 

f Impure r 111 ventilation, 

From ! atmosphere (vocation, etc. 

without 1 T . . . f ° ver he * tin S 

I Impoverished 4 rooms, improper 

I atmosphere I ventilation, etc. 

f Original : heredity 

From ( Defective I f Disease 

within 1 lung tissue 1 Acquired -J expos- 

l t lure, etc. 

The law of tuberculosis expresses it more tersely : The 
death-rate from tuberculosis is in direct ratio to suspension 
of atmospheric influence. 

There have been many solutions of the sphinx-like rid- 
dle, tuberculosis. The writer thinks the above will stand 
all tests. 

Let us resume our catechism. Why should measles 
and pertussis be placed in the category as causing acquired 
defective lung tissue and pneumonia left out? It is true, 
tuberculosis sometimes follows pneumonia. The writer is 
inclined to think pneumonia more often supervenes upon an 
unrecognized incipient tuberculosis. The pneumonia runs 
its course and then tuberculosis, at this stage, is diagnosed. 
To answer the question more direct : in measles the rash 
covers the entire surface, cutaneous and mucous. During 
the eruption suspension of atmospheric influence must take 
place. The eruption disappears, but sometimes leaves an 
inflammatory thickening in the lungs. This causes con- 
tinued suspension of atmospheric influence, or the precedent 
state. The bacillus then enters and takes root. 

A double pneumonia is fatal. Lobar pneumonia usu- 
ally involves but a portion of one or both lungs. While 
this portion is involved the rest of the lung acts perfectly, 
but, of course, respiration is quickened. Hence no suspen- 
sion. The disease is of short duration and recovery is 
perfect. 

In pertussis there seems to be a continued inflammatory 



—140— 

action, which leads to thickening — suspension or the pre- 
cedent state. 

Observation shows tuberculosis often follows the above 
diseases. The explanation given seems the most sensible 
and comprehensive. 

It is fabled when Methuselah was 500 years of age, an 
angel awoke him and said : "Arise, Methuselah, get thee up 
and build thee an house for thou art yet to live 500 years." 

The reply of Methuselah is characteristic of a man in 
the prime of life. Said he : "If I am to live but 500 years 
why should I build me an house?" 

Whether the age of Methuselah be taken in a literal 
sense or not, this much is certain : Life at present is short- 
ened in years. 

Whether Methuselah lived in the open his entire so- 
journ or not this much is certain : The present manner of 
life shortens our years. 

What is a common cause of tuberculosis? Let us ex- 
amine. If the animal kingdom be taken as a whole we find 
two classes : They who roam at will and they who are sub- 
ject to the will of another. Or perhaps better, they who of 
necessity take physical exercise in the open air and they 
who from choice, or otherwise, do not take such exercise. 

Of the former class, we find all wild animals and all 
nomadic tribes, as the aborigines of our country. 

Of the latter class, all domestic animals and all civilized 
people, as the Americans and Europeans of today. 

Among the former, tuberculosis is unknown. Among 
the latter no less than one-seventh die of the disease. A 
marked contrast. Of the wild animals it is verily a "strug- 
gle for existence." 

One animal is preying on another, so each is on the 
alert. If it be not the pangs of hunger that cause exertion 
it is the fear of having to appease the hunger of another 
animal. 

So physical exercise is a matter of necessity. Activity 
is life. 

It is mainly so of an uncivilized people. The struggle 



—141— 

for existence is dominant. The females perform all man- 
ual labor, the males are trained in war and the chase. War 
and the chase are constant occupations. The tribes are 
constantly moving and live in the open air. 

As before stated, none die of tuberculosis. With do- 
mestic animals the case is different. The pet cat or pug 
sits quietly by the fire and lives wholly in the home. They 
are fed as the family and ofttimes receive greater attention. 

The domestic animal is fed and housed as the individ- 
ual owner. The stabled cow, the penned sheep, the unused 
horse are treated in like manner. 

Is tuberculosis prevalent among them? Yes, and please 
note the prevalence is in accordance to the law of tubercu- 
losis. The death-rate from tuberculosis is in direct ratio to 
suspension of atmospheric influence. 

Did you ever know of a daily used race horse dying of 
tuberculosis ? 

Do not unused stable-fed horses die of tuberculosis? 
Why the difference ? Lack of physical exercise — suspension 
of atmospheric influence. 

This statement is also true of the work horse. A 
horse constantly used in the open air seldom dies of tuber- 
culosis. Why not? Because physical exercise does not 
permit continued suspension of atmospheric influence. Can 
any one assign a logical reason why tuberculosis is more 
prevalent in the ox than in the horse? The difference lies 
in a difference of physical activity. 

All things considered, physical activity means preven- 
tion of tuberculosis. 

In these latitudes there are two conditions which com- 
pel mankind to bestir themselves, viz., poverty and riches. 

Both are blessings if rightly used. 

He who has not the wherewithal to secure the next 
meal is compelled to put forth effort either to work, beg or 
steal. 

He who has riches is compelled to care for them, or 
"they take wings and fly away." 



—142— 

The effort put forth to attain these objects is physical 
activity. 

The student of history will observe the immense in- 
crease in wealth in this country during the past few decades. 

He will also observe this increase is largely in the 
hands of a few. 

Immense wealth brings corresponding responsibility 
ofttimes not rightly used. 

Increase of poverty means increased dependence on 
those who hold the wealth. 

Ofttimes increased uneasiness* or dissatisfaction that 
the difference in the social scale is so great. 

Both the rich and the poor need education and moral 
restraint. They should ever strive to be more agreeable 
one to the other. 

Legislation should never widen the chasm between 
them; the trend should rather be to close. 

These facts are noted: 

1. Increase of poverty and riches. 

2. Entailed activity. 

Upon whom does this activity descend? 

The following picture presents : The rich, few ; the 
many, poor; the anxious, careworn parent; the idle or 
vicious child. 

In the home of the rich — superfluity, idleness, etc. 

In the home of the poor— penury, vagrancy, etc. 

What is idleness? 

What is vagrancy? 

An answer for both — physical inactivity. 

If physical activity prevent tuberculosis, what shall we 
say of physical inactivity? Does it not induce tuberculosis? 

What, then, is a common cause of tuberculosis ? 

Physical inactivity. 

In what way is physical inactivity a cause ? 

In that it allows suspension of atmospheric influence to 
take place in the individual. 

Suspension of atmospheric influence is tuberculosis. 

What is lacking ? 

The incentive to labor. 



—143— 

The rich man's child asks, "Why should I labor? 
There is no need." 

The poor man's child asks, "Why should I labor? 
There is no remuneration." 

Physicians, pastors, educators — all, teach the zvorthi- 
ness and necessity of labor. It is life. 

Say some, "A woman's work is never done." 

She suffers most from tuberculosis. 

Why educate woman to labor? 

Where does woman perform her work? 

Usually in the ill-ventilated home. 

Does the work cause tuberculosis or is the cause of 
tuberculosis to be found directly in the ill-ventilation? 

In every case in the ill-ventilation. 

The work as exercise is the salvation of many a woman. 

If, then, the house in which we live — our home — brings 
so much disease and death, Methuselah was wise in his gen- 
eration when he said, "Why should I build me an house?" 

Is physical culture a requisite in the education of the 
perfect man? 

When the Rt. Hon. W. E. Gladstone in his school days 
sculled two miles up the river Thames with his college 
friend, Hallam, he was developing that physical stamina 
which served him so long and well in after years. 

His friend Hallam, in being carried, enjoyed the com- 
pany, ride and scenery, each in itself a benefit, yet from 
these alone he received no physical brace or vitality to resist 
the inroads of disease. 

The life of the one proved a monument of achievement 
in deeds accomplished. The life of the other a monument 
of worth so soon to pass from mortal view. 

Here is a lesson to aspiring genius. Happy the one 
who clearly reads. The young man or woman who starts 
in life with a good physical and mental heritage, though 
poor in purse, should remember in these alone he has a for- 
tune. He should constantly bear in mind this fortune is in 
his hands for a purpose. That a right use of this fortune 
strengthens or increases it. A lack of use or abuse of this 



—144— 

fortune diminishes it in a like proportion. These truths 
are seen on every hand- 
Two persons of equal age and import start in the race 
of life. The trysting time is now at hand. The one moves 
on and accomplishes the cherished object of his life. The 
other speedily succumbs. Whence this difference? The 
one has received physical training for the race; he is pre- 
pared. The other has made no struggle and is unprepared. 
The struggle of existence is the preparation and oft- 
times determines the man. Physical training is assuredly 
necessary, let none think otherwise. 

In physical culture, what is the primary object? On 
this, as other topics, writers may differ, but the author 
takes it physical culture is for the development of the entire 
man. 

Physical culture is used in the training of certain mus- 
cles. If life be a foot race or boxing match the training of 
certain muscles may be all that is required. But life is more 
than these. Life is a complex entity in which there is 
accumulation, conservation and diffusion of energy. Do not 
misunderstand. No one of these factors work alone and of 
its own free will. From infancy to manhood it is largely 
accumulation. From manhood to old age it is largely con- 
servation. It may be, or it may not be, diffusion all the 
way. 

The primary object in physical culture is to awaken, 
hold in abeyance and give forth at the proper call. In other 
words, physical training should include moral and mental 
training. He who acquires much in youth has much to 
diffuse in manhood or old age. He who does not conserve 
the energy received has no staying power in the continued 
race, and falls by the wayside. He who best accumulates 
and conserves has most to diffuse. 

The life of each individual may be compared to a dy- 
namo. Electricity is developed, stored and diffused. If 
the generator be small there is little electricity to store or 
diffuse. If the storage be small there is no need to develop 
until readv to use. If the diffusion be faultv there is little 



—145— 

use to develop or store. The perfect dynamo has these 
under control. So the perfect man. Some men have 
strength — development. Some have staying power — stor- 
age. Some know when to give forth — diffusion. The per- 
fect man has each under control. 

The historical Samson had cumulation and diffusion — 
no conservation. Failure. 

The college student, Hallam, had conservation and 
diffusion — no cumulation. Failure. 

Gladstone had cumulation, conservation and diffusion. 
Success. 

Perhaps this may be illustrated in another way : Many 
cannot resist temptation — cumulation and diffusion — no 
conservation. 

Moral training or physical restraint may be necessary. 
Many, through heredity or defect, have conservation and 
diffusion, no cumulation. If due to heredity the strong arm 
of the law should assert its right for the benefit of future 
generations. 

Many have cumulation and conservation, no diffusion. 
Among this number are the multi-millionaires in health and 
strength, who acquire and hold but never give. Lazy lumps ! 
What a shame! 

The primary object of physical culture should be to 
render the circuit complete and under control. 

Should physical culture be alike for all? 

As anatomy tells us the human body at all times has 
essentially the same number of muscles, so one naturally 
infers if one muscle needs training, then all. As the rela- 
tive strength of these muscles varies with the individual, so 
one naturally infers the exercise should be adapted to indi- 
vidual capacity. The rule should be: No muscle to lie idle, 
no muscle to be exercised above a healthy endurance. 

Ought physical culture or training be continuous ? 

The Christian might ask, ought prayer be continuous, 
meaning ought the believer to pray once, twice or three 
times per day during life. The answer would be, "Pray 
without ceasing." Meaning that at stated intervals the 



—146— 

Christian should hold communion with God. The fre- 
quency of these intervals must be determined by the needs 
of the soul. So in physical training. The needs of one's 
system must determine the frequency or duration of exer- 
cise. In eating, one partakes of food when he is hungry. 
The frequency of eating or amount of food must be deter- 
mined by the needs of the system. Some people do not eat 
enough ; they starve the body at the expense of the intellect. 
Others eat too much, so much, indeed, they scarcely know 
they have an intellect. 

With prayer and physical exercise the average man is 
not apt to overdo. Yet it must be admitted with the physi- 
cal wage earner there are many, many times when the sys- 
tem becomes exhausted. This should not be. The wage 
earner should have his periods of work and repose as others. 
The brain worker should take a certain amount of physical 
exercise each day, preferably in the open air, the amount to 
accord with the physical make-up of the system. If the 
quantity of food ingested be large the exercise shold be 
more active or prolonged. If small, then less so. The 
brain worker will hold out longer and accomplish more by 
observing this simple rule. Work or physical exercise is 
intended for all. There is no exception to it on this earth. 

To briefly resume: All should engage in continuous 
physical culture for perfect development. 

What does perfect development bring ? Freedom from 
tuberculosis. 

Ought promiscuous spitting to be stopped ? 

Under a republican form of government all its people 
are free and equal. 

Equal in that each has certain inalienable rights which 
cannot be abrogated. 

Free in that each does as he please, provided he does 
not displease his neighbor. 

As a people we are a nation of spitters. This arises 
from two causes. The use of tobacco and the prevalence of 
catarrh. 

For the habitual user of tobacco, the writer has little 



—147— 

sympathy. For the sufferer from catarrh he has great 
regard. 

"Cleanliness is akin to godliness." 

All tobacco users are filthy. It is impossible for them 
to be otherwise. While there are grades of filthiness, from 
the esthetic smoker, whose breath at times emits perfume, 
to the mendacious chewer and spitter, who wallows in saliva, 
all are filthy. 

"Let him which is filthy be filthy still." 

In one who suffers from climatic influence, or a consti- 
tutional dyscrasia, the case is different. He, too, may be 
filthy, yet ofttimes it is not a filthiness from choice. The 
filthiness is thrust upon him. 

We are a nation of spitters. 

Let him who thinks otherwise enter the crowded church 
or hall and examine. Let him move through the crowd 
around the central stove of eating house or saloon, or glance 
into the cuspidors of the more modern hotel. This, we 
think, will convince. 

Ought promiscuous spitting to be stopped? 

In attempting to answer this question there are two 
things to be considered. 

(a) Is spitting beneficial to the one so inclined? 

(b) Is spitting injurious to the neighbor? 

On the answer given these questions must hinge the 
oughtness of promiscuous non-spitting. 

No tobacco user can swallow his saliva continuously. 
He must, in some way, eject it. Spitting, then, in his case, 
is beneficial to himself. If it be shown spitting is injurious 
to the neighbor, the oughtness of it should be considered, 
for no one in health is compelled to, use the weed. Its use 
is simply a habit. To the neighbor who wears long dresses 
and asks, "Why should I be compelled to endure the nui- 
sance of spitting?" the user of tobacco may reply, "Why 
should I be compelled to endure the nuisance of trains?" 

The one is as much a nuisance as the other. 

Should one who views life from a practical or esthetic 



—148— 

stand-point ask the same question, no such reply could be 
given. 

The way, then, is plainly open to the tobacco fiend. 
To at once stop its use or care for his siliva. 

On this subject the common law and the law of eti- 
quette should be plain and harmonious. 

There ought to be no mistake. 

Having considered the status of the tobacco user, let us 
now consider the rights of the afflicted. His rights, it 
seems to the writer, have been flagrantly violated in all dis- 
cussion of the past. At the outset, it may be asked, what 
right has the afflicted that may not be granted to the healthy ? 
If the healthy have no right to spit on the floor or carpet, 
in the hall or home, why should this right be accorded to 
the sick? Let us be candid. 

No such right is granted. 

Whether in sickness or in health no man or woman can 
claim the privilege of indiscriminately spitting. 

It is a nauseating and filthy habit and should be so re- 
garded by all intelligent people. 

At the same time there are extenuating circumstances. 

It is to these we would, at present, direct attention. 

1. The patient is suffering from climatic influence. 
He has recently taken cold, or has an influenza. He must 
needs cough and hawk and spit. The patient and his 
neighbor must bear these patiently. What we cannot amend 
we must endure. But please observe in every case it -is the 
plain duty of the patient to care for his sputa. He has no 
right to place this sputa in any way to inconvenience his 
neighbor. If so placed, his neighbor has the right to object. 
This much for the ordinary cold. 

2. The patient is the subject of a constitutional dys- 
crasia. The dyscrasia is a something, not of the patient's 
volition. Perhaps it is due to marriage, or manner of life 
of his ancestry — a thing beyond his control. It is the pa- 
tient's duty, so far as in him lies, to ameliorate or remove 
this dyscrasia. It is his duty to care for his sputa. Is this 
all? Has the public no duty to perform? While the pub- 



—149— 

lie is asking so much of the patient, from a mere esthetic 
point of view, ought not the public to discharge its plain 
duty in securing a more healthy generation in the years to 
come? Why should the public demand so much of the in- 
dividual, while it accords so little to the individual in 
return ? 

3. The patient has tuberculosis. Laying aside, for 
the moment, the cause of tuberculosis — whether the germ 
tubercle bacillus, or suspension of atmospheric influence — 
laying aside the contagiousness of tuberculosis — whether all 
or none in health take the disease — ought promiscuous spit- 
ting to be stopped? Yes, from an esthetic stand-point. 

Assuming tuberculosis is due to the germ tubercle ba- 
cillus, ought promiscuous spitting be discontinued from this 
stand-point alone ? No. Tubercle bacilli are found in every 
atmosphere. If the direct cause of tuberculosis, all would 
have the disease regardless of sputa. 

Assuming suspension of atmospheric influence to be 
the primary cause of tuberculosis — that no tuberculosis 
exists without first having this condition or precedent state 
— ought promiscuous spitting be stopped? No. If sus- 
pension of atmospheric influence must be present before 
tuberculosis can exist — if the ventilation be perfect — what 
matters it whether there be one or one thousand tubercle 
bacilli per cubic foot of air space? 

In the contagiousness of tuberculosis the writer is in- 
sistent. There must first be the precedent state before one 
can take the disease. 

It is not the number of tubercle bacilli in the air, but 
the presence or absence of the precedent state that deter- 
mines the contagiousness of tuberculosis. 

When one insists that all sputa should be burned or 
destroyed, from an esthetic stand-point, he is consistent 
with the facts in the case. 

When one demands destruction of sputa on the ground 
of its becoming dried and mingled in the air, and thereby a 
source of contagion to the healthy, he is asserting that 
which the facts in the case do not justify, that which he 



—150— 

cannot maintain. 

What leads to a belief there is other cause of tubercu- 
losis than the germ tubercle bacillus ? The fact that only a 
portion of human kind take the disease. If the tubercle 
bacillus be the direct cause of tuberculosis, all should take 
the disease, for all are exposed. 

What other reasons can be assigned? The tubercle 
bacillus is not found growing in the healthy individual. If 
the direct cause, the growing bacillus would be found in 
health. 

Is there other reason to confirm this belief? A period 
of indisposition on the part of the patient always precedes 
the entrance of the growing bacillus. If the bacillus be 
the direct cause, this period would be superfluous. 

In what way can we determine the presence or absence 
of this period? By clinical observation and history. 

In what way is this period of indisposition naturally 
produced? By suspension of atmospheric influence. 

Can we induce an artificial indisposition which will 
allow the living tubercle bacillus to enter one's system and 
take root; if so, in what way? By suspension of atmos- 
pheric influence. 

If one has this natural or acquired indisposition, or 
precedent state, in what way can he rid his system of its 
baleful influence? By physical exercise in the open air. 
The air is necessary, in that it supplies a long-felt need in 
oxygen restored. The exercise is necessary, in that it ex- 
pands and contracts the lungs, thereby forcing the air into 
the remotest cells. 

Is, then, the open-air treatment of tuberculosis cura- 
tive? In every case, in the first stage of the disease, i. e., 
before the tubercle bacilli take root. 

Is this truth an important one? The most important 
in the history of the disease. A knowledge of this truth 
and its practical application would revolutionize treatment 
and control the disease — tuberculosis. A truth of such 
magnitude is worthy consideration. This truth is formu- 
lated in the law of tuberculosis. 



—151— 

If, then, we rightly understand the writer, is the oxy- 
gen treatment of tuberculosis beneficial? It is beneficial, 
more especially in the first stage of the disease, i. e., before 
the entrance of the tubercle bacilli. 

Is the oxygen treatment curative? It is never curative 
in that it does not remove the first cause of the disease, viz., 
suspension of atmospheric influence. The treatment re- 
stores oxygen, ad interim, and thereby temporarily builds 
up the system. The cause of the disease, being constantly 
at work, gradually undermines the system and results in 
the death of the patient. Oxygen treatment alone does not 
cure tuberculosis. 

You have spoken of the open-air treatment. In what 
way is this treatment curative? The living tubercle bacil- 
lus cannot enter one's system and grow unless there first be 
the precedent state. The open-air treatment is curative in 
the first stage of the disease in that it drives away the pre- 
cedent state and thus prevents the entrance of the tubercle 
bacillus. With an hereditary taint this treatment must be 
continuous in order to prevent the disease. Herein is shown 
the ill influence, in treatment, of the tubercular dyscrasia. 
An universal marriage law and correct living are the only 
two methods that will thoroughly eliminate this dyscrasia. 

We have hospitals in this and other countries in which 
the cure of tuberculosis, in all its stages by the open air 
treatment, is announced ; are these statements reliable ? It 
is a sad commentary on human nature that statistics, like 
many other things, are modified by the "almighty dollar." 
But such is the truth. We have professors who are utter- 
ing half truths in statistics year after year ; men who have 
not the vital stamina to tell what they truly know. While 
we must recognize a difference between the teacher and the 
thinker, at the same time please reflect — we are teaching a 
future generation. Men and women are rearing an edifice 
of knowledge that in future use will be cumbrous machin- 
ery. So in the statistics we gather ; many of these are 
senseless verbiage. To return: Tuberculosis is caused by 
suspension of atmospheric influence. To restore this influ- 



—152— 

ence would restore the patient to health, provided there be 
no destruction of tissue, etc. There are in nearly all hos- 
pitals tubercular patients with destruction of tissue, etc.; 
therefore, but few of these patients are restored to health. 
Let us illustrate: Mr. A runs a circular saw; in its use he 
loses a hand ; can any hospital restore that hand as before ? 
Mr. B has tuberculosis ; cavities are discovered in his lungs ; 
can any hospital fill those cavities with normal lung tissue? 
The age of miracles is past. Why attempt to show the 
present age a miraculous one? The age is not miraculous. 
The attempt, if made, is simply a shield in order to more 
effectually grasp the mighty dollar. Let us be honest. 

In general terms, does the open air treatment benefit 
tuberculosis? Yes, in many ways (our own classification is 
used.) In the first stage, as already shown, this treatment 
is curative. In other words, tuberculosis is under control 
in the healthy subject. In the diseased subject, as in hered- 
ity, or in the second or third stage of tuberculosis, it is dif- 
ferent. In heredity, a soil is already prepared; if the con- 
ditions of life be favorable, the bacillus at once takes root ; 
not so in perfect health ; a condition of life may be favorable 
to the growth of tubercle bacilli, and yet they do not grow. 
Why? Absence of the precedent state. Again, in the 
tubercular dyscrasia as inherited, there must be a constant 
battle to hold the condition of the system at the normal ; not 
so in perfect health. Many flagrant violations of law may 
occur, and yet recovery is possible. Is the force of heredity 
seen? 

In the second and third stages of the disease the pre- 
cedent state is of necessity present. There are present the 
growing bacilli, and, in many cases, abscess cavities. It 
has been shown that the open air treatment cannot restore, 
lost tissue; lung tissue, broken down, has disappeared for- 
ever. What can the open air treatment do in these cases? 
Prolong life and afford a small chance of recovery. In all 
these cases there is still left a small amount of working lung 
tissue. By the open air treatment this small amount of tis- 
sue is placed at its best ; by its proper use, with no incum- 



—153— 

brance other than the growing bacilli, the patient is kept in 
better condition and life is prolonged. Constitutional treat- 
ment in connection affords the best results. A good family 
history with open air and constitutional treatment will re- 
store a share of these cases to health, and in every case will 
prolong life. In truth, this treatment is the best known to 
the science of man. At the same time it must ever be re- 
membered prevention is the great field in which to labor. 
Tuberculosis can be controlled. 

Cannot exception be taken to the language used in 
speaking of treatment? To the followers of Koch, perhaps, 
TR will rank first ; to those having hospitals at command, 
other systems will continue in vogue. To the one who 
carefully examines causes and effects, the writer thinks 
there is but one answer : The open air treatment is the most 
potent, if not the only reliable therapeutic agent. The 
writer has seen consumption recover under open air treat- 
ment without the administration of any drug whatever. 

On what is this answer based? Careful observation — ' 
to the readers who have carefully observed the old-time 
homeopathist, of triturations and dilutions, you have seen 
one thing: The great care used in selecting and arranging 
the patient's room; the largest room, the one with the most 
sunlight and best ventilation is the one chosen. The 
homeopathist succeeds in the treatment of tuberculosis 
where the regular has failed. Why? Certainly not on 
account of the medicine given, for flies sip copiously, night 
and day, from the dilutions without apparent effect. Why 
the benefit? On account of the open air treatment. 

Is tuberculosis contagious? 

This question is often asked by near relatives, friends 
and attendants ; those who directly minister to the wants of 
the patient. As a question, it is a perfectly proper one and 
should be answered in all sincerity. 

Before directly attempting an answer, perhaps a pre- 
liminary statement is necessary. 

Among civilized nations, tuberculosis is found in nearly 
every locality, is fatal in its nature, and is by some thought 



—154— 

to be on the increase. Since the advent of the germ theory 
of the disease many worthy people have held tuberculosis 
should be isolated as variola, etc., on account of its contag- 
ious nature. These people have even invoked the aid of law 
to prevent contagion — to protect the healthy. 

Is tuberculosis contagious? 

The word contagious is used in its ordinary sense. By, 
is a disease contagious, is meant, is a disease catching? 

Can one take the disease from another while staying in 
his house or room as nurse, or doing the ordinary work of 
the household? In other words, does one ordinarily take 
tuberculosis while pursuing these vocations? 

Is tuberculosis contagious? 

John Smith is twenty-seven years of age, has a loving 
wife with five small children and the disease tuberculosis. 
No insurance. Mrs. John Smith is twenty-five years of 
age, of nervous temperament ; does the work of the house, 
but has heard of the germ tubercle bacillus. Mrs. S. thinks 
dearly of John, but occasionally thinks of herself and fam- 
ily. Very natural. She consults her family physician, who 
is a germ theorist. 

"Doctor, I am afraid of catching this disease. Is tu- 
berculosis contagious ?" 

"Madam, your question is a very timely and pertinent 
one. I have been in attendance on your husband now for 
about one month. There is no question whatever as to the 
nature of his disease. Had thought several times of telling 
you to be more careful, but I have been busy, extremely 
busy. Mrs. S., you ought not to enter your husband's 
room. There is great danger of the tubercle bacilli enter- 
ing your system." 

"But doctor, what shall I do?" 

"You ought to hire a nurse at once. A competent and 
thoroughly trained nurse; one who clearly understands the 
situation." 

"But, doctor, how shall I pay him?" 

"Really, madam, I do not know. The law makes no 
provision." 



—155— 

"Doctor, will the nurse not take the disease? If the 
bacilli enter my system, will they not enter the system of 
the nurse as well?" 

"Madam, you do not understand. The nurse will take 
proper precautions." 

"Well, doctor, can you not give these precautions to 
me? Why hire a nurse?" 

"You have thus far discharged the duties of nurse. 
Your work has been done well, yet there are certain precau- 
tions that should be observed. All sputa should be burned. 
The object in this is two- fold: To prevent contagion on the 
part of attendants and to prevent reinoculation on the part 
of the patient." 

"Doctor, since my husband's sickness I have burned all 
sputa, as an act of cleanliness." 

"As I said before, you must not enter your husband's 
room. There is great danger." 

"Doctor, in what does the danger consist?" 

"What a question! In what does the danger consist? 
The air is full of living tubercle bacilli. The danger con- 
sists in these bacilli entering the system and causing tuber- 
culosis." 

"But, doctor, does not all air contain tubercle bacilli? 
Why should I be denied entrance to my husband's room?" 

"True, the tubercle bacilli are ubiquitous, but they are 
not so plentiful elsewhere as in your husband's room." 

"Doctor, how many tubercle bacilli does it take to start 
tuberculosis ?" 

"Well, really I do not know, but I suppose one or two 
would be all that is necessary." 

"Doctor, I have read there are many microphytes in 
the ordinary atmosphere. Now, according to your theory, 
in order to prevent tuberculosis, one would have to stop 
breathing." 

"Madam, there are so many things you must learn from 
experience. As I said before, you ought not to enter your 
husband's room." 

"But, doctor, how shall I attend to his wants?" 



—156— 

"By means of a telephone. So far as I know, no ba- 
cilli travel by wire." 

"Doctor, shall I convey his food and clean linen and 
arrange his bed by telephone?" 

"Certainly, madam, certainly." 

"Doctor, ought I to wear deceptive gloves while mak- 
ing my husband's bed?" 

"Deceptive? You mean asceptic. There are so many 
mistaken terms in science." 

"Doctor, you say my husband's room is improper in 
that it contains multitudes of tubercle bacilli. What would 
you say to a larger room with more perfect ventilation?" 

"Madam, this is not in accord with approved treat- 
ment." 

"But, doctor, would not a larger room with perfect 
ventilation lessen the number of tubercle bacilli per cubic 
foot of air space? Would it not render the room more fit 
for a nurse to enter?" 

"Robert Koch, the greatest scientist who ever lived, 
does not treat tuberculosis in that way. He huddles his 
patients in small rooms. This is approved treatment." (Dr. 
Hyndman, Cincinnati, O., speaks of the number of patients 
in a small room.) — Lancet-Clinic in Koch's hospital. 

"It seems to me, doctor, that science could yet learn a 
little common sense. However, so long as you are attend- 
ing physician, I will obey orders." 

"On one condition, madam, I will allow you to enter 
your husband's room : Provided you wear a mask well 
•padded with cotton wool. The wool strains out the tuber- 
cle bacilli." 

"Yes, doctor; thank you. I can then look at my dear 
husband." 

"Yes, madam ; but you must refrain from speaking." 

"In regard to diet, madam, it matters little what you 
give your husband to eat, provided it be served in the proper 
manner." 

"Doctor, what do you mean by proper service?" 

"All food contains tubercle bacilli. The food and 



—157— 

dishes should be perfectly clean and all milk sterilized and 
the dishes placed in the hot oven before and after use." 

''Doctor, do you allow butter to your patients?" 

"Butter in limitations is quite nourishing. It is used 
with the usual precautions." 

"What do you consider the best way to sterilize butter?" 

"Butter should be boiled. It is best eaten while hot 
through a sterilized tube. There is then no danger of in- 
fection." 

"Doctor, what shall I do in regard to my five dear 
children?" 

"Madam, I have not read the latest article by Count 
Von Blaunerhasselt, but I am of the opinion you ought to 
take unusual precautions." 

"Doctor, what would you think of sending them to their 
grandfather's? He lives on a farm far in the country. 
The children could have abundance of exercise in the open 
air and plenty of nourishing food." 

"Madam, if you value their lives as anything at all, 
you should do no such thing. To insure safety, your 
children should be placed in a germ-proof house and the 
T. R. treatment commenced at once." 

"Doctor, of course I have a mother's fear, but is the 
T. R. treatment dangerous?" 

"The danger from the T. R. treatment is now at a 
minimum, but of course in all cases there is danger." 

"Doctor, what is the object of T. R. treatment?" 

"The primary object is to induce immunity." 

"May I ask one other question, doctor? What is meant 
by immunity?" 

"There are two forms of immunity, madam. Immun- 
ity to tuberculosis and immunity to tubercle bacilli. It is 
of the former kind I now speak." 

"Doctor, do you mean by immunity to disease that one 
has the disease all the time?" 

"No, madam; the very opposite. When one has im- 
munity to disease he never has the disease ; he never has 
the disease so long as he is immune." 



— 158— 

"How long does immunity last, doctor?" 

"That depends. On an average something more than 
two hours." 

"Well, doctor, of course I am a woman, but this does 
not seem like immunity to disease, but rather a continuation 
of immunity." 

"As I was about to remark, there is another form of 
immunity, viz., immunity to the tubercle bacillus. If one 
should be so immune that the germ could not enter his sys- 
tem and grow, as this germ causes tuberculosis, the person 
so immune could not take the disease if he desired to do so." 

"Doctor, that is just the immunity I desire for my dear 
children; please explain." 

"Virulent living tubercle bacilli are injected into 
healthy guinea-pigs." 

"Doctor, you do not mean to so inject my children, do 
you?" 

"If left alone, in every case, these guinea-pigs die of 
tuberculosis." 

"Doctor, my children are not guinea-pigs." 

"If these guinea pigs are injected with T. R. in time, 
the animals do not die of tuberculosis." 

"Doctor, you stated the guinea-pigs are healthy. Why 
have them die at all?" 

"As I said before, the germs of disease must be in- 
jected." 

"Doctor, as I said before, I am a woman. If my babe 
takes tuberculosis, are the germs of disease injected? Does 
not a condition of system allow the tubercle bacilli to enter ? 
Does the T. R. treatment or injection eliminate the condition 
of system? If not, does it or can it cure the disease tuber- 
culosis ? Doctor, please answer my question : Is there not 
always a condition of system that precedes the natural en- 
trance of the growing tubercle bacillus? If yes, the T. R. 
treatment cannot cure tuberculosis." 

Is tuberculosis contagious? 

Yes, if you have the precedent state. 

No, if you have it not. , ] 



—159— 



AN OUTLOOK. 



To one who travels the northern portion of our country 
and sees the boulders scattered here and there — some large, 
some small, all rounded as if by gradual attrition and con- 
tinuous movement — he is led to inquire, whence came these 
and what cause can be assigned? It was the observation of 
these and similar data that led to the glacial theory, now 
generally adopted by scientific men. But what caused gla- 
ciers in this latitude? Evidently, it was change in climate, 
but in the attempt to explain this man is baffled at every 
step. 

Thus it often is in the elaboration of any theory. In 
science as in religion we see through a glass darkly, and yet 
we see. To the physician who has sat by the bedside and 
ministered to the wants of his patent in the dread disease 
tuberculosis, and witnessed a decline more apparent day by 
day, though steadily laboring to combat symptoms, he is 
led to inquire, why this dark blot on present civilization and 
just stigma to medical science? 

It is this and similar observations which has led to var- 
ious theories of the disease. One sees symptoms in tuber- 
culosis which are distinctly nervous, and he declares it a 
disease of the nervous system. Another, as he travels, be- 
holds germs or vegetable growths in all tuberculous tissue ; 
to him these cause the disease; he at once formulates and 
advocates the germ theory. 

The writer plainly asserts he is not satisfied with either 
theory. Perhaps it is because he has one peculiar to him- 
self. Some people are built in this way. They are satis- 
fied with nothing unless it conforms to their ideas. Be this 
as it may, the writer gives his theory gratis, and the rea- 
sons are accompanied therewith. What more can be asked ? 
We speak plainly, it is not our purpose to unjustly judge 



—160— 

any theory, but to give as best we may our reasons for dis- 
carding the same. In doing this we do not arrogate all 
knowledge to ourselves, but we speak in order to be clearly 
understood. 

If the disease tuberculosis be of nervous origin on ac- 
count of the nervous symptoms, why not in the same breath 
declare it of muscular origin on account of the muscle wast- 
ing seen in every case? It seems to the writer this would 
be just as consistent. One thing medical men should know : 
An attendant symptom is not necessarily a cause of disease. 
Every disease has symptoms peculiar to itself. Symptoms 
correctly observed render the diagnosis clear. But watch- 
ing symptoms is not determining the cause of disease. 

If germs alone truly cause tuberculosis, if the germ be 
ubiquitous, as most writers claim, why do not all take the 
disease? Why do any escape? If true, the result is mar- 
velous in the extreme. Herein is the greatest fallacy of 
the century. 

It is assumed that the plant tubercle bacillus is a para- 
site. It is a parasite only in the sense of its growing on an 
animal already diseased. It never grows on the healthy 
animal. This was pointed out many years ago and has not 
been successfully refuted. Where are our living germ theo- 
rists? Living germs are abundant. 

One thing must be evident to every unbiased mind : A 
plant cannot grow without a proper soil. Whence comes 
the soil? The germ theorist assumes the tubercle bacillus 
grows indifferently in any soil. The writer thinks this is 
no such thing. In every case the soil must be prepared. 
Ofttimes no doubt it is prepared unwittingly, but prepara- 
tion, as the seed, alike is requisite. This all must learn. 

In many ways the soil is analogous to the soil of the 
farm or garden. As is well known, all soils are not alike 
productive. Some must be rendered fertile; some need 
great care in preparation ; some are but waiting for the seed. 
Each soil needs its particular care or attention. This the 
wise farmer learns from sad experience. So, in tuberculosis 
as with greatness, some are born great, some achieve great- 



—161— 

ness and some have greatness thrust upon them. Some in- 
herit a soil, some acquire a soil and some have a soil thrust 
upon them. In tuberculosis this may seem strange, start- 
ling and discordant, yet it is nevertheless true. It is the 
discordant note in this disease that renders the harmony 
more complete. 

My attention was early called to law in tuberculosis. 
What is meant by law? Plainly speaking, law is uniform- 
ity of action. Wherever uniformity of action is seen there 
must be law. Examples : A drop of water undisturbed 
assumes a globular form — law ; the moon revolves around 
the earth, and the earth around the sun in regular periods 
of time — law. In the higher mathematics should we dem- 
onstrate that planets pass over equal areas in equal times we 
prove a law. Law is an order of sequence. Should the 
same thing occur year after year without variation, this is 
law. My office rent is due every six months. This is the 
law of the firm. Of this we are conscious. The physician 
should adopt just such a law, only made monthly, some 
think weekly. 

Laws may be divided or classified as known or un- 
known. Known laws are accepted without question, or 
should they be questioned, may be vertified. Unknown laws 
are discovered like planets, and after discovery may be seen 
by those having eyes or intellect. ( ' Seeing is believing." 
They then become known laws. 

A word in this connection : To the average mortai 
mathematics is dry and uninteresting. The writer has a 
foundness for this particular study. At college in this 
branch he was excelled by none. Some think mathematics 
of little value. A distinguished language professor said to 
his class this year : " All we need of mathematics is to be 
able to break a five dollar bill properly and receive the cor- 
rect change." Is this true? Would it not be nearer correct 
to speak of language on this wise ? " All we need of lan- 
guage is to be master of our own." But we confine our 
remarks to men writing for the medical profession alone. 
Allison Drake on " Twentieth Century Medicine a Liberal 



—162— 

Education," in the Colorado Medical Journal, speaks of 
" the legerdemain of algebra," and " the incapacity of pro- 
fessional mathematicians for dealing with problems of mixed 
uncertainties as notorious." 

The writer thinks if we are truly dealing with problems 
of mixed uncertainties, the legerdemain of algebra is just in 
place. But where do we find such problems ? In that book 
of formulas known as analytical geometry, which requires a 
knowledge of algebra, geometry and trigonometry; no leg- 
erdemain or mixed uncertainties are found. Remember, 
these formulas are used in calculations, as calculus, etc., 
which are very accurate. " Be not deceived." True, some 
professionals are so merged in their calling they know little 
else; this, however, is just as true of musicians, mechanics, 
etc., as of mathematicians. Let no sane man decry the 
accuracy of mathematics. Mathematics alone is the exact 
science. 

The truth of the matter appears to be this : Whatever 
trains the mind to comprehend clearly and reason accurately 
should be used in the preparatory education of the physician. 
Mathematics in the training of the reason is transcendent ; 
at the same time he who is most familiar with other lan- 
guages is most master of his own. In medicine one should 
alike be master of language and reason. 

We said our attention was early called to law in tuber- 
culosis. We also said we are extremely fond of mathe- 
matics. In conning the authorities we find no one dies of 
tuberculosis in the frigid zone. Why ? Do they all freeze ? 
No one lives there ? Please let this pass at present. We 
are seeking law. 

We put down at once what is given by standard medi- 
cal authorities. It reads as follows : 

TUBERCULOSIS. 

Zone. Death-rate. 

Frigid o 

Torrid Small 

Temperate Great 

We then seek reasons for the above and in so doing 



—163— 

liberally consult the authorities. It excites one's risibility 
to think of some of the reasons given. Take the frigid 
zone in illustration. One author finds as a reason for the 
zero death-rate in this zone that the people eat a vast amount 
of fat meat. Hence, the remedy in any climate — cod-liver 
oil, glycerine, cream, etc. Just reflect one moment. More 
fat is eaten per capita in the temperate zone than in the tor- 
rid zone, yet the death-rate is larger ; so that in giving this 
reason there is neither law nor common sense. 

Another, a germ theorist, finds the reason very simple. 
The climate is so cold the tubercle bacillus is frozen. Hence 
the remedy is to cook the bacillus in situ and cure the disease 
in any climate. The writer passes this man by calling 
him a very simple re as oner. 

After long consultation and many sleepless nights we 
found a something that fills the vacancy. My readers have 
probably heard of it before, viz., suspension of atmospheric 
influence. We now fill this vacancy and ask all readers to 
look : 

TUBERCULOSIS. 

Zone. Death-rate. Suspension. Ratio. 

Frigid o o 1 

Torrid Small Small 1 

Temperate Great Great 1 

Please notice the regularity. Webster says whenever 
a regularity is traced, law must exist. A law is formulated. 
In tuberculosis the ratio between death-rate and suspension 
of atmospheric influence is always constant. We prefer the 
following construction : The death-rate from tuberculosis 
is in direct ratio to suspension of atmospheric influence. 
Take your choice ; they are the same. Let us see if this law 
holds good in its practical application. " The proof of a 
pudding is in the eating." 

The first column, under death-rate, is standard author- 
ity, and, so far as the writer knows, has never been called 
in question. The second, under suspension, is our own, 
and, of course, is debatable. Let us see — no suspension in 
the frigid zone. How do you make this appear? The 



—164— 

houses or hunts are made of snow or ice. Suspension in 
such huts is an impossibility. In snow the interstices are 
filled with air and where there is an abundance of air there 
can be no suspension ; ditto in ice, though not so great. The 
dry atmosphere of a cold climate keeps this air contained in 
these meshes or interstices in constant circulation. Writers 
who have lived in this zone tell us under these circumstances 
it is impossible for one to take cold. Taking cold, I appre- 
hend, is not clearly understood. 

How about small or little suspension in the torrid zone ? 
With few exceptions the life is wholly in the open air. The 
climate is hot and arid as a whole and permits or allows 
this. Were the inhabitants of this zone as cleanly, and, in 
fact, as civilized as in the temperate zone, the writer sees 
little reason why tuberculosis could not be eliminated entire. 

What reason is assigned for the great death-rate in the 
temperate zone? In this zone the reasons are multifarious. 
Our life, for the major part, is an in-door life, i. e., is in in- 
closed buildings ; these are ofttimes but illy-ventilated. Life 
in the open, at best, is only for a few days in the year. 
While the fathers and sons live for the greater part in the 
home, the mothers and daughters live almost exclusively in 
the home. Vast numbers live in the shops and factories ; 
these are poorly ventilated and filled with dust and smoke. 
This dust and smoke in the lungs prevents a perfect aera- 
tion. Add to this the consumption of gas or fuel which 
abstracts oxygen. These factors are constantly at work, viz., 
indoor life, impurities in the air, lessened amount of oxygen. 
Remember, also, suc"h factors as these : Thickened lung 
tissue from changeable temperature, etc. ; heredity, in that 
there is deficient lung tissue, capacity, etc. ; heedlessness, 
in that there is ignorance of the true cause of disease. 
Hence, the great death-rate is caused by great suspension of 
atmospheric influence. 

In December, 1890, the author published an article in 
the Cleveland Medical Gazette, in which occurs the follow- 
ing : " Nature controls tuberculosis beyond the polar cir- 
cles ; nature controls in great measure tuberculosis within the 



— Ino- 
tropics. Nature is doing all she can for us. Can we help 
her ? I believe we can ; that the day is not distant when 
tuberculosis will be banished from our midst." 

A law is given in tuberculosis — as we prefer to call it, 
the law of tuberculosis. The writer is aware this law is an 
innovation. In medicine as in kindred sciences, innova- 
tions arise. We trust this one will lead to a more clear 
comprehension of this most deadly disease. To the author 
it is not distinctly new. Fourteen years ago it was written 
on a blackboard and presented to the Portage County Medi- 
cal Society. Some of the members of said society are yet 
living ; others have passed to the great beyond. The law is 
presented in all sincerity. The writer knows whereof he 
speaks. He is assured. 

Notice the working of this law as seen in animate na- 
ture around us. No wild animal has tuberculosis. Why? 
No suspension of atmospheric influence. Domestic animals 
have tuberculosis. W r hy? Suspension of atmospheric in- 
fluence. Of animals dying of this disease, which have the 
greatest proportional fatality? Those having the greatest 
suspension. Wnich the least fatality? Those having the 
least suspension. 

Again, in treatment. What remedy is of most avail in 
any stage of the disease ? A life in the open air — removal 
of suspension. What can be said of incurable cases? The 
suspension cannot be removed. 

Notice the law: The recovery in tuberculosis is in di- 
rect ratio to removal of suspension. 



—166— 



VAGARIES. 



' 'But,' I sez, 'can you tell how, the little seed of this 
weed goes down into the earth and selects just what she 
wants out of the great store-house below ? She never comes 
out in a pink head-dress or a yellow gown. No, she always 
selects what will make the blue. It shows that it has life, 
intelligence, or else it couldn't think, way down under the 
ground, and grope in the dark, but always gropin' just 
right, always a thinkin' the right thing, never, never in the 
hundreds and thousands of years makin' a mistake. Why, 
you couldn't do it, Josiah Allen, nor I couldn't. And we 
set and see these silent mysteries a goin' on right at our 
door-step, day by day and year by year, and think nothin' 
of it, because it is so common. But if anything else, some 
new law, some new wonder we don't understand comes in 
our way, we are ready to reject it and say it is a lie.' " — 
(Samantha at Saratoga.) 

The advent of the germ theory of tuberculosis brought 
with it many vagaries. Some of these have become obsolete, 
while others are more modern — the old and the new. 

The endeavor is made at this time to point out a few of 
these whimsical notions, wild fancies or extravagant ideas. 
The object is to touch upon nothing that has distinct merit 
per se without giving the same due credit. 

Foremost among these vagaries is, perhaps,' the notion 
the plant tubercle bacillus is a bug, its extract a veritable 
bug- juice. Who first gave loose rein to his imagination in 
this regard is unknown. Whether he spoke of verities or 
uncertainties is unknown. Certain it is, some editors and 
many writers still cherish these ideas. Associations linger. 

The tubercle bacillus is not a bug, but is a plant, deriv- 
ing its nourishment from the soil. As all vegetation re- 
quires a soil, so likewise the tubercle bacillus. 



—167— 

Perhaps this may be best expressed in postulates : 

1. No vegetation can grow without a soil. 

2. The soil must be peculiarly adapted to the plant. 

Of the first, no question will be raised ; it is self-evi- 
dent. Of the second, it is known that certain soils are 
adapted to certain plants ; other soils will not raise them. 
The wise planter selects the soil by direct observation or 
experiment ; otherwise he meets many failures. 

A second vagary is, the tubercle bacillus will grow in- 
differently in any soil ; in other words, as parasites are found 
indifferently on sickly and healthy animals, so likewise the 
tubercle bacilli. The outgrowth of this second vagary is 
due to the common belief that the tubercle bacillus is a 
parasite. It is a parasite in the sense that it is found grow- 
ing in the living animal ; it is not a parasite in the sense 
that it is found growing in all animals, regardless of their 
condition. No tubercle bacilli are found growing in 
healthy animals. A manifest distinction is here made. If 
then, the tubercle bacillus be a parasite, it is a parasite of 
disease and the disease takes precedence. 

From observation the tubercle bacillus is found grow- 
ing in a soil prepared by suspension of atmospheric influ- 
ence. It naturally grows in no other. 

By experiment a soil may be so prepared and the plant 
at once takes root. Hence, we conclude there is a law of 
vegetable growth for this particular plant. As the seed of 
this plant is everywhere present, as the soil is in various 
stages of cultivation or preparation, so tuberculosis is seen 
in various stages of development. 

One who takes into consideration only the plant, re- 
gardless of the soil, is like the farmer who cares only for the 
seed. From him the soil receives no attention. To this 
farmer a small or large crop is equally satisfactory. The 
ordinary farmer is not so constituted. So we think one 
should take into consideration the condition of the animal 
as well as the plant. Certain it is, unless the soil be correct, 
there will be no growth. 



—168— 

Vagary three: The tubercle bacillus is dangerous. An 
early experience in hospitals where operations were per- 
formed under a continuous spray, a later experience where 
patient and instrument were injured by so-called germicides, 
a still later where no care was taken except cleanliness, 
makes us somewhat sceptical of injurious germs. But, as 
the heading shows, we confine our remarks to this particu- 
lar germ, and assert, if the reasoning thus far be correct, 
no tubercle bacillus can be dangerous unless the subject of 
infection have a favorable soil. The observation and rea- 
soning along this line has been somewhat curious : 

(a) Historical — Many observers of the past have re- 
garded tuberculosis as infectious or contagious. Else why 
so many cases in one family or community, or nation? 
Why so universal a disease? Per contra, others have re- 
garded the disease simply as a decline, and as attributable to 
many causes, the family, community or nation being sub- 
ject to said causes. Some trust statistics. 

(b) Statistical. — At various times statistics have been 
compiled. The reader can judge of their value. They are 
gleaned somewhat as follows : Drs. A, B, C, etc., to the 
number of five hundred, are written and asked to answer 
the following question : "Do you consider tuberculosis 
contagious?" One hundred pay no attention to the letter, 
one hundred and fifty-seven answer in the affirmative, one 
hundred and forty-three in the negative and one hundred 
are in doubt. The compiler concludes: "The majority 
believe in contagion ; great care should be exercised." Then 
follow rules for guidance — when, where and how to spit, 
etc., etc., etc. Others use reason alone. 

(c) Rational. — If it be true the plant tubercle bacillus 
naturally grows only in a soil produced by suspension of 
atmospheric influence ; if it be true we can control, in the 
majority of cases, the soil so produced, it follows we hold in 
our hands a method of effectual control of tuberculosis, and 
that without germ intervention. This is the writer's belief. 

The germ theorist reasons as follows : If the plant 



—169— 

tubercle bacillus causes tuberculosis, there is danger. We 
must escape or destroy the germ if we would be safe from 
the disease. Cotton wool, germicides and serums are in 
demand. 

These same theorists might claim, if tuberculosis be 
caused by suspension, why shun the danger? One can no 
more catch suspension than he can catch a broken limb or 
a shooting star. The writer claims : True, one cannot catch 
a suspension, but he can avoid a suspension and thereby 
avoid the disease. This leads to another method which we 
call: 

(d) Sythetical. — We may hang our harp on the wil- 
low of imagination, yet the most skillful player brings forth 
only a weird and hollow sound. We are in a strange land. 

In all logical reasoning we must deal with facts. Lee 
us try to give them : 

(a) Tubercle bacilli are everywhere present and can- 
not be eradicated. 

(b) They take root and grow when there is a favor- 
able soil. 

(c) The soil is produced by suspension of atmospheric 
influence. 

(d) Suspension of atmospheric influence may be con- 
trolled. 

This means the control of tuberculosis — nothing more 
nor less. 

But suspension is already present : 

(a) From ignorance or neglect. 

(b) Heredity, for which we are not responsible or 
reprehensible. 

(c) Disease, to which we are all subject and some time 
must yield. 

Therefore, we must deal with facts as they are, and 
not as we ideally wish them to be. 

We have, then, two entities ever present, viz., suspen- 
sion or the soil, and the tubercle bacillus or the seed. The 
soil and seed determine the harvest. 

"What shall the harvest be?" The seed cannot be 



—170— 

sensibly limited. The output is constant. The soil cannot 
always be governed. It is sometimes beyond control. 

Mankind are truly frail creatures, yet when we once 
clearly recognize the true cause of tuberculosis and the 
means of prevention, I am satisfied the above vagaries will 
be forgotten and the dreadful scourge tuberculosis will be 
sensibly diminished — the lessening not attributable to any- 
thing except a higher knowledge of the disease. Let us 
labor for this happy consummation. It will abundantly 
reward us. 



-171— 



MEDICINE. 



The field of medicine is an extensive one. Each prac- 
titioner, from his particular angle, views to the extent of 
vision. As when one looks on the lake or ocean he sees as 
far as he can see, so when one introduces or examines a 
system of medicine his field is commensurate to the percep- 
tives exercised. No two people see exactly alike. No two 
have the same perceptives. Hence, the diversity in vision 
and perception. 

As in a coast survey many angles are taken before a 
complete map is made, so in medicine each should assume 
many angles before establishing a system. Many of us are 
extremely narrow. A system should be like the ocean, 
comprehensive and deep — so comprehensive as to include all 
knowledge, so deep as not to be readily sounded. A sys- 
tem of similar magnitude demands attention today. 

Nothing is more evident than that present medicine is 
beyond the comprehension of any.. To some it is neither 
here nor there — a veritable ignis fatuus. 

Competent men have declared there is no such thing as 
medicine, and, to their own satisfaction at least, have proved 
it. "When Bishop Berkeley said there is no matter and 
proved it, 'twas no matter what he said." So when the 
medical nihilist says there is no medicine and proves it, 
there is no medicine in what he says, and ordinary mortals 
believe it. A practitioner who gains this idea had better 
drop from the race. Honestly, he has nothing to do — a 
disease, but no remedy. 

Others declare medicine is uncertain. What is not un- 
certain in this life? To strike out the uncertain things 
would not only root up medicine, but law and theology as 
well. Medicine is far more certain than either. In truth, 
what could exist ? The farmer would no longer till the soil, 



—172— 

crops are so uncertain. The merchant would not cross the 
ocean or venture in trade, it is uncertain. It is said noth- 
ing is certain in this life except death and taxes. These are 
uncertain in time and magnitude. If we hold fast only to 
the certain things, poverty would soon be the lot of all. 

Say some : Medicine is empirical. The first treatment 
of disease must be empirical. We know as yet absolutely 
nothing. We gain our information from observation and 
experiment. Human nature is full of ailments. Nature's 
store-house is full of remedies. We seek to determine what 
will alleviate distress or aid nature in removing disease. 
Various ingredients, singly or combined, are tried and the 
results made known. This is empirical. When like results 
are obtained by a concensus of observers this is then called 
science in medicine. How else could the value of a remedy 
be determined than by experiment? How else the worth of 
a medication than from observation? Experiment or ob- 
servation at the first must ever be empirical. 

As the world becomes older, as disease and remedies 
become known, we have not only all past experimentation 
and observation, but also a large field for original research. 
In this field we are placed as at the first. It is one of un- 
known disease and untried remedies. So that so long as 
human nature remains as it is, subject to sickness; so long 
as the world remains as now, full of the untried, so long 
there will be the two distinct fields — experimental and prac- 
tical. These will be taken up respectively by parties best 
adapted to the work. The separate fields will not long re- 
main fallow or barren. Each will be cultivated and abun- 
dant harvests secured. 

For the past few' years there has been a decadence 
along this line. This may be attributable to three or more 
causes : 

1. The desire of some to shine in medical literature 
who closely follow these writers do not see the same results 
before a proper standard of refinement is attained. They 
as shown. We must then unlearn what is learned amiss. 
This retards progress. 



—173— 

2. Experiments on animals are assumed to give iden- 
tical results as the same experiments made on man. As- 
sumption is not always truth ; many times it is the opposite. 
This we all learn sooner or later. 

3. Another fault should be readily seen. Experi- 
ments made on the healthy animal are assumed to produce 
the same result as if made on diseased man. How a 
rational being could make so illogical an assertion is past 
finding out, yet such seems to be. That similar statements 
are made may be ascertained by consulting the ordinary 
text-book in medicine. So many grains of calomel, etc., 
produce a certain condition or result in healthy dogs, rab- 
bits, guinea pigs, etc. If given to diseased man we expect 
similar results. We may expect, but, as a matter of fact, 
we do not see. Any practitioner knows that Messrs. A and 
B may be alike diseased and a remedy given to the one will 
not always product the same result if given the other. 
Mankind differ in susceptibility both in health and disease. 
How, then, could we rationally compare the action of reme- 
dies in health and disease, much less in animals diverse in 
nature and habits? 

These are among the irrational things found in medi- 
cine. There are many others equally as flagrant. 

4. As a small observer of the times and seasons, we 
must also think this decadence is due in part to the drop- 
ping of the old and tried remedies and the grasping for the 
new. This is seen more particularly in the adoption of the 
various serums in the treatment of disease. It is observed 
in certain conditions that germs or microbes are found 
growing. Why they are thus found is not asked, but the 
conclusion is at once reached that they cause the condition or 
disease named. How to eliminate or dislodge the microbe 
is the question for solution — no other. The various meth- 
ods proposed would baffle the forest hunter in his search for 
game. A trap, snare or gun would constitute the hunter's 
outfit. Not so the germ-hunter. He proposes to secure 
the invader by means of his own extract — a novel method. 
What is also remarkable, the extract must be of a certain 



—174— 

brand, usually foreign. This certainly appears dishonest. 
The writer thinks all dishonest methods should be shunned, 
even though they assume the guise of novelty. Wrong is 
wrong. 

This method of treatment being so contrary to reason, 
some have tried to rule it out by means of ridicule. But 
ridicule is not argument. It does not convince. There is 
one way in which the inconsistency can be properly shown, 
and that is by comparison. Suppose you discover a drove 
of hogs in your neighbor's potato patch. What is your 
first honest impulse? To> inform the neighbor. What is 
the neighbor's impulse? Perhaps to swear, then to remove 
the hogs, repair the fence and ask for damage. What is 
the future action? To keep the fence in repair. This is 
an order of sequence. As a physician you discover growing 
tubercle bacilli in a patient's lungs, or perhaps, better, a 
condition of system in which the bacilli will soon enter and 
grow. You are paid for the discovery. What should be 
your honest impulse ? Should you spend the entire time at 
the expense and danger of the patient in trying to trap, en- 
snare or kill the growing bacilli by means of an extract? 
Should you not act as well, as sensibly, as honestly, by a 
patient as by a neighbor? If not, why not? Should one 
spend the entire golden hours of the precedent state, and 
while tuberculosis can be controlled, in vainly endeavoring 
to secure a possible immunity to the germ? This is what is 
being done. 

When one looks about him and sees the inconsistency, 
the foolishness, the dishonesty of his fellows in medicine, he 
is led to exclaim: "Great God! Can it be possible man is 
created in Thy image ?" Brethren, repair the fence. 

Medicine not subject to law ! We are accustomed to 
see things move with regularity and precision. The sun 
and moon rise and set at regular intervals. Mankind are 
born, they grow and die. Waters run, smoke ascends, the 
tide rises and falls. These things we are accustomed to 
and of them we take but little note. In medicine things are 
different. Here there is no regularity. For pain or sick- 



—lio- 
ness one takes nothing, another medicates, a third prays, 
and all complain. Each thinks his the proper way. Why 
this diversity? Why not more unanimity? Why not a 
universal method? 

How in regard to theology? One believes in God and 
prays, another believes in God but not in prayer. A third 
believes in neither God nor prayer, etc., etc. In truth, we 
find many peculiar beliefs. 

Note this connection in medicine and theology: Nearly 
all believe in something ; the lack, if any, is in unanimity or 
method. This lack, in medicine, is the one thing of all 
others which makes the field so extensive. Each has a 
field. No two fields are alike. A system must compre- 
hend or include all fields. There seems to he no other or 
better way. Let us enlarge our borders. 



—176- 



DEEP BREATHING VS. TUBERCULOSIS. 



One-half of the earth's people are poorly fed. The 
reason is obvious. It is not that Mother Earth fails to 
yield her sixty or one hundred fold, but that the hand has 
been negligent or slothful in preparing the soil or planting 
the seed. 

Prosperity and effort are closely allied "The hand of 
the diligent waxeth rich." Indolence has no incentive to 
labor. As a rule, famine stalks rampant in its fields. India, 
today, is an illustrious example. We note also famine and 
its twin sister, pestilence, thrive most among the heathen or 
half-civilized. Christian civilization knows nothing of fam- 
ine and little of pestilence from personal experience. They 
are practically driven from its borders. 

While we thus exalt civilization of this generation we 
must also note some of its faults or defects. Foremost 
among these is imperfect aeration of the blood. A vast 
majority of the civilized are consuming less oxygen than 
they should. The reasons are multifarious. 

One would naturally think the primary cause for this 
fault, defect or wrong consists in ignorance of the value of 
oxygen. The writer is inclined to think this view an in- 
correct one. The civilized are well informed. That it is 
not ignorance alone is certain from the fact that physiology 
is taught in all the public schools. The laws of the land 
allow or compel attendance at these schools, so no plea of 
ignorance can be raised. 

But why is it assumed there is imperfect aeration 
among the civilized? What is aeration? Aeration is ven- 
tilation of the blood as it passes on in the life current. 
Aeration takes place through the lung tissue. It naturally 
occurs in no other way. The lungs of man, as the gills of 
fish, permit the oxygen to enter the system. If the lung 



—177— 

tissue be imperfect, thickened, or in any way defective, aera- 
tion is incomplete, i. e., insufficient oxygen enters the 
system. 

Should one consume less food than is required by the 
system, or should the food be of imperfect quality, there 
is a starvation of the body. The same may be said of oxy- 
gen. One who takes in or consumes less oxygen than he 
should, either from ignorance, perversity or inability, the 
system must suffer. In one sense it is oxygen starvation 
or famine. 

Should one by deep breathing or inhalation take in 
more oxygen, or should one breathe a purer air and thereby 
(receive a larger supply, every want in the system is met and 
the famine is declared off. This is what deep breathing 
loes in certain states of the system. It removes the famine. 

But first, why is it thought there is imperfect aeration 
among the civilized? One-seventh of all deaths are due to 
consumption or phthisis pulmonalis a4one. If we add to 
this number others who die of distinctly lung disease, as 
pneumonia, etc., the proportion seems abnormally large. 
No such proportion is seen among native tribes remote from 
civilization. To the writer, the reason seems obvious : 
They have a more perfect aeration. The perfect aeration of 
native tribes secures a practical immunity from lung dis- 
ease. Civilization can show no such immunity. 

What does aeration accomplish? As the oxygen enters 
the lung tissue it comes in contact with the venous blood 
and changes it to arterial. The impure blood is thereby 
rendered pure. The body, by this means, is kept in a 
healthy condition. This of itself is one of the essentials to 
long life. In order to have pure blood our food must be 
ample in quantity and quality. The oxygenation of the 
blood is just as essential. 

We look on famine-stricken India with hearts of pity 
and sorrow. Pity, there is so much suffering; sorrow, the 
people are so unwise and improvident. India could look on 
us with the same commiseration. The Americans and 
Europeans are so talented ; they have every resource of art, 



—178— 

science and literature, yet they are actually dying of starva- 
tion — an oxygen famine. The East India men should help 
us. No doubt they would had they the zeal and knowledge. 
The zeal, perhaps, could be attained by a better food supply, 
the knowledge by the exercise of an acute observation, cer- 
tainly not by consulting standard authors, who tell us so 
much of disease germs and their action. 

What else does aeration of the blood accomplish ? The 
food we eat sustains us or builds up our system as we digest 
or assimilate the same. Without digestion and assimilation 
there can be no true growth or strength added to our frame. 
To every student of physiology it is known that the lacteals 
empty the chyle, for the greater part, into the thoracic duct 
and from thence it is poured into the venous circulation. 
All chyle passes into this current. It here becomes subject 
to aeration in its round of the circulation. What does aera- 
tion do to this new current which enters the channel for the 
first time? It seems this is the last creative act, if we may 
so speak, in the formation of the new blood corpuscle. If 
so, it must be a very important one in the animal economy. 
New blood corpuscles are being formed, while at the same 
time the old are revivified. These two actions are con- 
stantly going on during aeration, are imperfectly performed 
during imperfect aeration, and stop when aeration ceases. 
It is seen that if every part of the human machinery be in- 
tact except aeration there is here found sufficient cause for 
impurity of the blood and scantiness of the red blood 
corpuscles. We may give eliminatives, we may ingest a 
bettter food supply, we may order ferrum redactum ad 
libitum, but we do not reach the true cause of the difficulty 
until we establish a more perfect aeration. 

Herein lies a secret in the treatment of many diseases. 
The disease tuberculosis, which is caused, we are told, by 
the germ tubercle bacillus, originates in this way. The 
first stage of tuberculosis is simply a faulty aeration. The 
bacillus enters secondarily — is never a cause of the disease. 
The faulty aeration may be due to many causes, but the re- 
sult is one and the same — tuberculosis sooner or later. The 



—179— 

remedy lies in the correction of this fault. It may take 
years to teach this simple truth, but it will eventually be 
accepted, and we will look back at the amazing folly of hav- 
ing once thought an infinitesimal germ caused the serious 
disease tuberculosis. Colorado's burden will then be les- 
sened and the world will breathe freer and easier, with a 
purer blood supply and an enlightened conscience. It is this 
field of original research that has remained so long fallow 
that is destined to yield an abundant harvest on proper cul- 
tivation. Let us each, with God-fearing assiduity, sow and 
reap as best we may and patiently await our reward. It 
will assuredly come and that with thanksgiving and joy. 

We stated the quality and number of the red corpuscles 
is dependent on the perfection of aeration. Let us see if this 
be correct as to its practical workings. Take, for example, 
the ordinary student life at college. Of course, we are 
aware there is great difference in the student life of today 
and that df twenty years ago. There has been improvement 
on the social side, larger physical culture, more out-door 
exercise, etc. In fact, there has been a constant change, 
and that for the better. Yet, after all, student life is stu- 
dent life — a host of duties, incessant cramming, and for the 
studiously inclined, but little exercise. Many students are 
constantly tired, easily exhausted, nervous and irritable. 
What is lacking? A pure blood supply. Of this there can 
be no question. What is the remedy? Physical exercise 
in the open air, more perfect aeration of the blood or hema- 
tosis. In the writer's judgment there is no question but 
that mental and physical training should be conjoined. All 
schools should be conducted on this basis. 

For further illustration take the ordinary housewife, 
who does, for the greater part, her own work. What is her 
life? A constant round of duties in her household, never 
fully done. From early morn till latest eve it is constant, 
never-ceasing work. "A woman's work is never done." 
What are her cares ? For family, home and self. Self usu- 
ally comes last. Her wants are many, but her greatest is 
pure oxygen in her own home, or time and opportunity for 



—180— 

out-door exercise. She regards neither, but toils on, a poor 
weak, anemic creature, and dies, most often, of phthisis 
pulmonalis. Could her untimely death have been avoided? 
Is civilization in any wise to blame? These are questions 
the twentieth century will be called to answer. Is not their 
consideration proper now ? 

But perchance the woman's sphere is not among the 
toiling millions. Her life is one of so-called social joy and 
gaiety. It is calls, balls, parties and receptions, of late 
hours, untimely meals of indigestibles, society's loud call 
for dress improper, etc. The life, ill- ventilation, etc., cause 
rising with languor and the noon day sun. Envy, jealousy 
and rivalry enter this life, but not more often than imperfect 
oxygenation of the blood. Society has yet important lessons 
to learn. Who would dare dictate to fashion? 

May be the life is that of a wage earner, and who is 
not? If so, it is so much work for so much remuneration. 
We enter not the vexed question whether the pay be suffi- 
cient for the labor. This is left to others. The question 
with us is, is the ventilation ample? Workmen are often 
crowded ; the air space is insufficient and the room is dusty, 
or perhaps the lights are consuming too much oxygen. 
The remedy must meet the requirement. 

In all these cases systematic deep breathing in the open 
air will overcome the difficulty if taken in time, provided the 
fault be remediable. It will benefit the patient even though 
the cause be continued. But the benefit in the latter case 
will not, of course, be permanent. Permanent benefit means 
freedom from tuberculosis. 

A question now arises : What faults are and are not 
remediable? If the fault be not enough oxygen in the 
room, if an irritant dust, gas or vapor, if a use of the upper 
air passages of the chest only, due to tight lacing or other 
cause . removable, these are remediable. If by heredity we 
receive a lung tissue incapable of perfect aeration under the 
most favorable environment, if from continued exposure, 
taking cold or other cause we acquire a thickened lung tis- 
sue incapable of perfect aeration, these, of course, are not 



—181— 

remediable. Deep breathing cannot alter permanently an 
hereditary or acquired lung tissue. Deep breathing calls 
into exercise the healthy lung tissue we possess, and aids 
the patient in his effort to secure a better blood supply. 
This alone places him on a higher plane of health and en- 
ables him to more effectually resist the encroachments of 
disease. In other words, one who so acts keeps his system 
in a condition in which the germ tubercle bacillus does not 
enter and grow. He who so acts has a perfect immunity to 
the disease tuberculosis. The number of germs in the at- 
mosphere is of little moment provided there be a perfect 
aeration of the blood. 

Now please understand we do not advocate deep breath- 
ing as a cure-all for every disease. Systematic deep 
breathing, if the lung tissue be healthy, will insure a pure 
blood supply in so far as oxygenation of the same is con 
cerned. Oxygenation of the blood, it will be found, is the 
essential element in the prevention of the precedent state, 
or first stage of tuberculosis. If true, how essential is per- 
fect aeration in the prevention of the disease. If true, the 
law of tuberculosis stands demonstrated : The death-rate 
from tuberculosis is in direct ratio to abeyance of atmos- 
pheric influence. 

Deep breathing does more than the oxygenation of the 
blood. As a preventive to taking cold or the ordinary 
catarrh it perhaps has no equal. Deep breathing, then, not 
only prevents tuberculosis directly, but it also prevents the 
very causes which lead to the same. How essential is deep 
breathing ! 

It seems to the writer this article is incomplete until a 
relation between deep breathing and physical exercise is 
shown. In one sense deep breathing is physical exercise. 
In another sense physical exercise is deep breathing. Yet 
it must be evident to all they are not one and the same. 
One may breathe deeply with little exercise. One may exer- 
cise violently yet breathe shallow. Physical exercise should 
be such as to cause* perfect inhalation and exhalation. 



-182— 



AN AMERICAN NEED. 



"A just observation and reflection upon men and things 
give wisdom; these are the books of learning seldom read "' 
— Wm. Penn. 

The Americans as a people are well educated. Many 
things conduce to this end. Foremost among them a sys- 
tem of common schools prevail throughout the length and 
breadth of the land — the pride and joy of the nation. The 
children, when grown, have vivid recollections of these 
schools. Not only do they remember, but the habit of 
thought then and there formed follows them in after years. 
Early life is a period of inhibition ; not only so, we also re- 
tain what we see or hear. 

The child at school may be compared to a sponge. 
Whatever is presented is readily absorbed, so that, squeeze 
whenever you will, the child or man gives out that he has 
absorbed or inhibited. This is a sequel to the present sys- 
tem. Whether it be regarded a fault or not, this much is 
certain : There, is not that in us which tends to a vigorous 
growth or development. As writers and teachers we lack 
originality and force. The writer believes this a fault, 
one that should be corrected, or in some way avoided. It is 
our life. Wherein does the wrong or fault consist? In 
this : We take in or assimilate as presented ; we memorize 
and give out just as we receive. Such teaching or instruc- 
tion develops no originality. It is a parrot-like acquire- 
ment and delivery. Ages come and ages go and we roll on 
forever so. 

It is a similar system which has brought the Chinese 
empire where it is today. No people on this earth are bet- 
ter educated tnan the Chinese. Yet in true progress and 
clear ideas where are they? One thousand years behind 
the age. May it never be so said of America. 



—183— 

It is not the object to find fault with a system of edu- 
cation the like of which is not elsewhere to be seen — the 
rather to commend it. At the same time it must be 
remembered that all human systems are faulty. To elimin- 
ate a fault is to improve. the system. Do we desire improve- 
ment? Why object to an elimination? 

As before stated, in early life the receptive faculties are 
open. This is as it should be. The child imitates, receives 
and retains. As yet there is no cultivation of the percep- 
tives. The child sees nothing except through his teachers. 
As he grows why not occasionally let him look for himself ? 
He passes from grade to grade, and, if studious, becomes an 
encyclopedia of information, yet destitute of originality — a 
mere book-worm. 

As the best pastor endeavors to find work for each of 
his parishioners, and thus adds to or improves his talent, so 
the most capable teacher strives to develop in each pupil his 
powers of perception or originality. This is wise. Ency- 
clopedias are common. Book-worms are unnecessary. 
What the world wants is original thinkers for its advance- 
ment. The sooner we discover this truth the better for 
mankind. No discovery is probable by one who has been 
educated under the present system. The system itself blinds 
one to original research. It is a continual memorizing of 
what others have passed on or determined. 

That the writer is not giving vent to an hallucination 
may be seen by observing the high school graduate as he 
leaves his alma mater. Watch him! His unaided ability 
to secure a position and adaptability to gain a footing in the 
"struggle for existence" is child-like. He is a mere tyro. 
Place him on his feet, tell him what is to be done and how 
to do it, show him what is expected of him, and if he be 
faithful he learns more of practical worth in one year than 
in the many years previously. The world's book of prac- 
tical suggestion and information is now open to him for 
the first time. Is he educated to read this book? We 
think not. 

The same may be said of the ordinary college graduate. 



—184— 

Note the length of time before he finds a place adapted to 
his abilities. When out of school he is like a landsman at 
sea. Perhaps he begins with some menial employment much 
to his distaste, if none other offer. By diligence he rises 
step by step and from his chaos of information he discovers 
there is little available at present. The bent of inclination, 
or more often the solicitations of friends, determines his vo- 
cation. All may go well. Very often everything goes ill, 
or it is rough sailing from the start, and the voyage proves 
uneventful. 

The great trouble is we are made too dependent on some 
one else. Teachers are not always present. There are 
some things we must observe for ourselves, else we do not 
know. Birds and flowers and trees, etc., do not grow with 
names stamped on them. 

To be familiar with these objects we must learn them 
from nature in nature's school. So in science ; science of 
today is not the science of yesterday or tomorrow. It is 
changing. He who reads science truly must walk as in the 
day, with both eyes open, recognizing all men, paying 
deference to none. He alone can read wisely. 

"A just observation and reflection upon men and things 
give wisdom; these are the books of learning seldom read." 
Give us more self-reliance and greater originality ; these are 
potent factors in the world's evolution. 

After the classical course in the schools comes the fit- 
ting of oneself for professional life — a great work. It is 
said the major part of our great men are college bred. This 
at best is saying but little, for all of our children must have 
more or less of college training. If, then, we have distin- 
guished men at all they must of necessity be from this class. 

The question under consideration is, do our strictly 
college-bred men show marked traits for original research? 
Are they distinguished along the lines of acute observation? 
Do they not work in channels or grooves in which they have 
been taught? Do they not hold and reverence the authori- 
ties ? Are they not, as a rule, inferior in wisdom to the so- 
called self-made men? 



—185— 

Our greatest artists have ever copied from nature. 
Why should we, the students of nature, ever be following 
the scholastic method? 

Let us think wisely, but let us think for ourselves, 
remembering there are "Sermons in stones, books in run- 
ning brooks and good in everything." 



—186— 



THE DAWNING. 



Within memory of the present writer a health officer 
declared one dying of consumption should not be carried in 
a public conveyance unless the casket be hermetically sealed. 
Reason : The danger from germs is so great the public de- 
mands precaution and protection. 

Germs, in some localities, are yet considered dangerous 
— dangerous in that their true action or condition of growth 
is not clearly understood. We must live and learn. 

Thanks to an enlightened public sentiment, the above 
order is obsolete. Other orders will be obsolete ere long. 
The light is gently breaking, and soon we will behold the 
sun in his effulgence. The writer thinks he will bring heal- 
ing in his wings. Give us the light ! 

For the past two decades we, as a people, have been 
harassed by the announcement that milk and its products — 
cheese and butter — are full of tubercle bacilli. We have 
also, during the same period, been studiously taught that as 
tubercle bacilli cause tuberculosis, these products are dan- 
gerous and should be inspected. A government inspector, 
as in Germany, has been urged. They say the people 
should be taxed and microscopists should pass sentence on 
all milk products placed upon the market. In this way 
tuberculosis could be controlled. In the meantime, until 
such inspection, we are advised to avoid cheese, boil butter 
and sterilize the milk, some even going so far as to counsel 
the eating of butter while hot through an aseptic tube. 

The writer, in his weak way, at various times has de- 
nounced these statements as fallacious. In the first place, 
he argues that tubercle bacilli do not primarily cause tuber- 
culosis. Tuberculosis is a constitutional disease, is based 
on law and the bacilli enter secondarily. The constitutional 
disease allows the natural entrance and growth of the 
germ. On this topic the author challenges controversy. 



—187— 

If tuberculosis be a constitutional disease, the disease 
preceding the germ's growth, milk is a diseased product 
before the entrance of the growing germ, therefore, kill- 
ing the germ by sterilization would not render it a perfect 
milk. This was shown by the writer in 1894 (vide Tran- 
sactions Ohio State Medical Society). 

If the milk be imperfect, milk products are also imper- 
fect, and no microscopist could detect this imperfection by 
the presence or absence of tubercle bacilli in said product. 
Microscopical inspection is therefore a useless expense. We 
pay taxes enough in this direction already. 

As stated, the writer has attempted to clear the way for 
microscopical entities. The replies have not been numer- 
ous ; in truth, as a rule writers have stood aloof. Is there a 
reason why ? From the hills of New Hampshire we receive 
the following: 

DANGER FROM MIL,K OVER-ESTIMATED. 

" Experiments as well as observations made in the last 
few years lead us to believe that tuberculosis is much less 
often communicated to man through milk than was form- 
erly supposed." — New Hampshire Sanitary Bulletin, Janu- 
ary, 1900. 

A closer observation, we feel assured, will lead to the 
conclusion that tuberculosis is not conveyed in this way at 
all, only under certain conditions. These will be spoken of 
later on. 

But who are making these experiments and observa- 
tions and what is their intrinsic worth ! The professors of 
the United States agricultural experimental stations are 
largely doing the work. The reports are of value according 
to the ability, honesty and common sense of the ones mak- 
ing them. Honesty we naturally expect. Some men are 
down-right liars. Common sense and ability, like twin 
sisters, walk hand in hand. Sometimes they are found 
alone, but only for short periods of time. They soon come 
together. They think so much of each other that they are 



—188— 

close companions ; nothing can separate. So far as we can 
ascertain, these men, for the major part, are germ theor- 
ists. 

For convenience, we divide them into theorists of the 
first and second waters. Theorists of the first water believe 
the germ per se is all in all. Prof. Robt. Koch and his con- 
geners belong to this class. Men of this stamp believe 
germs are veritable Napoleons, carrying devastation, disease 
and death. Theorists of the second water believe there are 
germs and germicides ; also a few other things worthy of 
notice. Dr. Russell, of Glasgow, Scotland, and Prof. Rus- 
sell, of the Wisconsin station, are men of this class. They 
believe germs have a mission, but it is inferior to the mission 
of the being they infest. In other words, men are superior 
to microbes. 

It is a common impression that first-water men are 
graduates of German schools, while second-water men have 
not crossed the North Atlantic. This is a mistake. Many 
first-water men are found who never crossed their state line, 
while some second-water men have visited many cities of 
Europe, and vice versa. Where one has traveled is of little 
worth. What does he know? This is what the world is 
asking. This it will ultimately find. One may deceive 
himself forever. He can deceive the vast intelligence of 
mankind but for a short time. Deception is short lived. 

From the Storrs Agricultural Experiment Station of 
Connecticut, eleventh annual report, we find experiments 
were made by feeding eight calves with milk from tubercu- 
lous cows, and that without infecting the former. These 
calves were fed for periods varying from three months to 
sixteen months without developing the disease. The report 
is closed in brief, from which we extract the following sen- 
sible words : " We know comparatively little regarding the 
conditions which favor the spread and development of tub- 
erculosis among animals or man." Evidently, the above 
was penned by a germ theorist of the second water. The 
second-water theorist knows but little in his own estimation ; 
the first-water theorist knows it all. When one rises to the 



—189— 

admission he knows but little, he is in position to take the 
first step to obtain more ; when one knows it all there is no 
incentive. He is practically dead and only needs burial. 

That little is known, as yet, regarding the conditions 
which favor the spread and development of tuberculosis 
among animals, may be seen by consulting Bulletin 108, 
June, 1899, issued by the experiment station located at 
Wooster, O. Ohio as a state is in many regards a leading 
one. The presumption is our men at Wooster are as com- 
petent as others. Why not? 

" The herd of cattle at this station was established in 
1894, by the purchase of a bull and two or three cows, each 
of the Jersey, Guernsey, etc. ... At the time these 
purchases were made the idea was prevalent that the tuber- 
culin test might be injurious to the health of the animal. 

For this reason the test was not insisted upon, etc., 
etc. On the station farm they were, of course, given good 
care, etc. All the increase was retained and by the spring 
of 1897 there were about eighty animals in the herd, all 
apparently in perfect health except two — a short horn cow 
and a Jersey bull, which had begun to show evidences of 
disease ; the cow by rapid loss of flesh and the bull by the 
growth in the throat of a visible lump, which caused diffi- 
culty in breathing. At the beginning of June both of these 
animals were killed, after having been subjected to the tub- 
erculin test. The cow was found to be in the last stages of 
generalized tuberculosis, and the lumb in the bull's throat 
was found to be due to the same disease. A supply of tub- 
erculin was then procured and in December and January 
further tests were made, and on June 8, 1898, fifteen cattle 
were slaughtered." — An Outbreak of Bovine Tuberculosis 
at this Station, p. 295. 

Then follow temperature before and after these injec- 
tions, and the result as found after death — a very interesting- 
report. 

These gentlemen should be congratulated. But the 
writer is not satisfied, in that the report is incomplete. It 
is incomplete in that the same number of animals were not 



—190— 

chosen by the tuberculin test and placed under similar con- 
ditions. We would then have two lists of animals, one 
chosen by general appearance or inspection and one by the 
tuberculin test. Should the first lot develop tuberculosis 
we could say, as in this case, it is lack of the tuberculin test 
in selection. Should the second, after the test, develop tub- 
erculosis, what could we say? Either the test is inefficient 
or there is other cause of tuberculosis. Which would it 
be? The writer asserts that after the tuberculin test tuber- 
culosis will develop, though more slowly. Why? 

In an article (Lancet-Clinic, November 20, 1897,) the 
writer held these conclusions : 

(a) Tuberculin determines the presence of growing 
bacilli. 

(b) Tuberculin has no value in diagnosis. 

(c) Tuberculin has no certain value in differentiation 
of first stage. 

(d) Tuberculin is sometimes dangerous. 

The writer holds these conclusions tenable. But our 
method of experimentation would be along a different line. 
We claim the precedent state is the first stage of the disease 
tuberculosis ; that this state is caused by suspension of at- 
mospheric influence and is based on law ; that suspension 
takes place from within and from without. Our questions 
for answer would be as follows : 

1. Does suspension of atmospheric influence cause a 
condition of svstem that allows the tubercle bacilli a natural 
entrance and growth? Take a healthy animal and subject 
it to this test. Answer, yes or no. 

2. Is there more than one method of suspension? 
Experiment on an animal. Answer, yes or no. 

3. Is there an anatomical difference in the lung tissue 
of health and of heredity, or of acquired influence? Sub- 
ject the lung tissue of each to rigid microscopical examina- 
tion or other scientific test. Answer, yes or no. 

4. Is there a test chemical, microscopical or other- 
wise, which will determine the difference in the blood of 
health and that of suspension of atmospheric influence? 



—191— 

Has science a delicate test? Apply this test to the living 
animal. Answer, yes or no. 

When these experiments have been made and correctly 
answered the law of tuberculosis will read as follows : The 
death-rate from tuberculosis is in direct ratio to abeyance of 
atmospheric influence. 



—192— 



MATHEMATICS IN MEDICINE. 



In my boyhood days I taught a winter school in the 

village of R . On entering the school building early 

one morning I found written on the blackboard the fol- 
lowing- : 

x + y = z 
x y = z 
The value of z, please? 

A question at once entered my mind. Who wants a 

solution? Several weeks later I learned a Mr. , who 

had taught in the village, desired one. 

Algebra is used but little in medicine, yet the writer 
thinks its introduction would lead to more accuracy in defi- 
nition, solve many hard problems and clear up some points 
now obscure. 

In illustration, take the word heredity. What is meant 
by heredity? The author defines it a prenatal inheritance. 
Whatever one receives in bone, blood, muscle, etc., prior to 
birth is by heredity. 

Let us see if this be true. Suppose one or both parents 
have a constitutional disease. Does "the definition hold ? If 
not there is a mathematical inaccuracy. If true, there is 
heredity in every distinctly blood disease, etc. We quote 
from " Tuberculosis or Consumption " as follows : ' You 
have a son to send to college. You call before you five 
leading clinicians in this state and put to each the test ques- 
tion: What factor is heredity in tuberculosis? Listen to 
the answers : Nothing, little, much, a great deal, all. What 
arises in your mind? One of two things — either these 
teachers are deceiving you or else they do not understand the 
business they profess. Who can instruct except they who 
know?" 

But, replies, a germ theorist, if tuberculosis be caused 
by a germ, which we have every reason to believe; if the 
growing germ be not transmitted, as experiments seem to 



show, what matters it whether heredity be much or little? 
Let us see : " It would seem much easier to formulate a 
cohesive and rational theory of the propagation of tuber- 
cular disease by infection than to account for it by heredity." 
(Ohio Agricultural Experiment Station, 1899, Bulletin 108, 
page 364.) 

The writer thinks this statement manifestly unfair. 
Remember, it is a public document, paid for by the great 
State of Ohio. The present writer has no motive othei 
than the advancement of medical science. He has a right to 
ask fairness. In what does the unfairness consist? In 
the ambiguous word heredity. Does heredity mean nothing, 
little, much, a great deal, all? Much depends on the 
answer. The majority of germ theorists claim heredity is 
nothing. In place of heredity put nothing, and then read : 
" It would seem easier, etc., to formulate, etc., by infection 
than to account for it by nothing." Not only would it seem 
easier but it would be easier. Of this the writer feels 
certain. 

Who claims heredity is all? Perhaps, all told, about 
five persons in the United States. To whom, then, is the 
committee of this experiment station talking? To these 
five. What does the great majority of the medical profes- 
sion hold? That heredity is a factor in tuberculosis — a 
variable factor. In some cases more, in other cases less. 
Refer to history. We will attempt to explain this later. 

Now look at the unfairness of the above statement in 
the light of mathematics. To compare a factor or part with 
an entity or whole as to the formation of a theory. Mani- 
festly unfair! One thing should be required of all public 
servants, viz., accuracy of statement, mathematics in defi- 
nition. 

Says the same authority on next page (365) : " In dis- 
cussing the question of heredity we should keep clearly in 
mind the biological meaning of the term." Exactly. This 
is just what the germ theorist does not do. The germ 
theorist claims the germ grows indifferently in any soil, i. e., 
the germ tubercle bacillus is the cause of tuberculosis. The 



—194— 

writer says not so. A soil must be prepared, i. e. } the soil 
must precede the growing germ. The germ theorist says 
that heredity is practically zero. The spread of the disease 
is from the germ alone. The writer says not so. Heredity 
is a factor. A soil may be transmitted. This soil aids in 
spread of disease. What is the order of the biologist? Soil, 
plant, growth or fruitage. Who 1 keeps the biological mean- 
ing most clearly? Mathematics in statement is required. 

Why is heredity a variable factor? Simply because it 
does not occur in two cases just alike. Let me illustrate. 
A father has tuberculosis ; his partner in life is in good 
health ; heredity in the child is one factor. Both parents 
are in good health ; heredity in offspring of these parents is 
another factor. Both parents have tuberculosis; the child 
in this case is still another factor. The mother has tuber- 
culosis, the father is in good health; the offspring are other 
factors. And so on ad libitum in as many conditions as the 
parents may be found. 

Again, the parents' occupation, environment, etc., 
cause a variable condition of blood due to perfect or imper- 
fect aeration, and this continued in the parents and trans- 
mitted to an offspring cause variation in heredity as a factor. 

The great body of physicians in America are as honest 
and as competent as any physicians on the face of this earth. 
In saying heredity is a factor in tuberculosis they express a 
great truth. It is a factor. But we must look yet further. 
Heredity is not the cause of tuberculosis. The cause is 
suspension of atmospheric influence. Heredity as a factor 
aids this cause in the extension of the disease. 

Moral: In the prevention of tuberculosis heredity must 
be regarded in connection with suspension. 

A question is now presented to the germ theorist, viz.: 
Why the diversity of opinion, past and present, in regard to 
heredity if the germ theory be true ? In heredity what is 
transmitted? If there be transmission at all there must be 
an entity. 

In order to understand this rightly, one must first 
clearly comprehend the law of tuberculosis. What does this 



—195— 

law teach or show ? In every case of suspension from what- 
ever cause, there is first an impurity of the blood due to im- 
perfect aeration. This, if continued, leads to a condition 
of tissue favorable to the growth of tubercle bacilli. The 
tubercle bacilli may be ubiquitous, but they are not omnis- 
cient. They grow, but they grow as all plant life — in a soil 
prepared. 

Now take this truth and use it in connection with hered- 
ity. What is the entity transmitted in heredity? A pre- 
pared soil. We have, then, in heredity an identical condi- 
tion as in suspension at the first. Suspension creates a soil 
and heredity transmits a- soil and they (the soil) are one 
and the same. 

Illustration : Mrs. A. has poor ventilation in her home. 
She becomes pregnant. During the months of gestation 
the imperfect aeration continues and it induces an impurity 
of the blood and a condition of the system or tissue favor- 
able to the growth of the tubercle bacilli. The fetus re- 
ceives the same blood and the same condition of tissue. Is 
this clear? This is heredity in the child. 

Should tubercle bacilli be found growing in the mother 
they may sometimes be found growing in the child. In 
either case, the mother or child alike allow the growth. 

Or, perhaps better, let the illustration be taken from 
life. Mrs. T., of E., has tuberculosis. She becomes preg- 
nant, and in due time is delivered. (I often wonder if abor- 
tion in some of these cases would not be justifiable.) The 
mother having suspension, there is suspension in the child, 
for, according to the author, in every case of tuberculosis 
there is suspension. Here, then, we have a babe ready for 
the growth of tubercle bacilli. In some few recorded cases 
the bacillus is found growing at birth. Dr. Jacobi, of Xew 
York, mentions such a case. Dr. Russell, of Glasgow, says : 
" These cases have an academic interest," thereby acknowl- 
edging their authenticity. The author thinks they have a 
greater interest than this. They have a world-wide inter- 
est. They prove a soil may be transmitted by heredity 
alone. Yet there are men in high places who deny to hered- 



—196— 

ity a value, and that before large classes. What astounding 
effrontery in the light of observation, reason and common 
sense. 

We now hasten to discuss another phase of this ques- 
tion. When a soil is induced by heredity, can it ever be 
changed back to its original condition? That depends, as 
in suspension, assuming there be simply a blood change or 
slight change in the tissue — yes. If the change be to disor- 
ganization — no. Destroyed tissue cannot be restored. 
Again, should there be disorganization with immense num- 
bers of tubercle bacilli, as there usually is, all effort to re- 
store health is in vain. The patient dies. Should enough 
sound lung tissue remain to insure fairly perfect aeration, 
under favorable conditions, health may be restored, though 
not normal. 

In what way may this change for the better be brought 
about? Just reflect one moment. What causes the dis- 
eased condition? Suspension of atmospheric influence. 
What removes the condition? Removal of suspension. 
The remedy is a simple one : Breathe pure air. 

Illustration : We stated Mrs. T., of E., is delivered of 
a child. What is its condition? One of suspension. The 
writer stated plainly to the parents the method to pursue. 
Remove the child at once from the breast, feed it cow's milk 
and let it have abundance of pure air. The mother said no 
— " If I die let the child die with me." Dr. W., of R., is 
called. He approves my opinion. The mother still says 
" No." An uncle, Dr. C, of C, is called, and he, holding 
the same belief, takes the mother to his home and leaves the 
child under the writer's supervision. In three or four 
months the mother is covered with the clods of the valley, 
but that child, today a man grown, is in perfect health. 
At the time of removal it was thought by the trio of physi- 
cians that the child would live but a few days. It had high 
temperature, colliquative sweats and hurried respiration. 

This history is but a counterpart of hundreds of others 
seen in every civilized land. Do all receive equally favor- 
able results? The writer thinks not. 



—197— 

Let us now return to our analysis of bulletin 108, same 
page. " The fact that the child of tuberculous parents de- 
velops tuberculosis is by no means conclusive evidence that 
it has inherited the disease in the sense that it may have 
inherited physical conformation or mental characteristics." 
The writer confesses he does not clearly understand what 
the author of the above means. That his own view on this 
most important topic be clearly understood, the writer again 
quotes from " Tuberculosis or Consumption :" " Children 
of consumptives, though the environment be changed at 
birth die of this disease among other healthy children bom 
of other parents" 

Example: Mr. B. marries Miss T. Result of union, 
one child. Mr. B.'s family history is unique. Of the en- 
tire family, nine in number, consisting of grandparents, 
children and grandchildren, all die of tuberculosis, except 
one child of three, of diphtheria. Miss T. is of good 
family history, but is delicate. Knowing the above history, 
the child is taken and reared among other healthy children, 
yet dies of tuberculosis, aged twelve ; the writer being the 
last attending physician. It seems to the author that in this 
case an entity was transmitted. Who can determine? 

Another question bearing on the above now comes to 
view. Is physical conformation or mental characteristic 
transmitted? Common observation shows that it certainly 
is. This child looks like her father. That child acts like 
his mother, etc. A likeness, similarity or entity is here 
seen. 

To be more explicit, is the entity of facial expression, 
etc., as seen in heredity, one and the same as the entity of a 
prepared soil by suspension ? It is not. In the former case 
it seems to be the result of a natural law or unfolding, 
whereas in the latter it is the result of a law violation or 
suspension. Each is an entity, and each comes under the 
head of heredity, but neither, so far as known is controlled 
by a germ. This may appear strange, but " truth is 
stranger than fiction," 

And now for a bit of experience. " The experience at 



—198— 

this station with tuberculosis in swine, given on another 
page, gives a forcible illustration of the manner in which 
the disease may even skip a generation, to reappear in full 
force in the next and yet not come under the law of heredity 
as above defined." 

Benjamin Franklin was pre-eminently a practical man. 
He said to England, in 1776, that the proper way to eat a 
large cake is to commence at the edge. The above is a 
large cake, and we propose to take Franklin's advice. Our 
nibbling is only at the edge. If the law of tuberculosis be 
true — and we think it is, ideally, at least — we can skip not 
only one generation, but five or six generations in succes- 
sion — ad libitum — and reinstate the disease in any genera- 
tion in less than eight weeks. This may also seem strange, 
but this in mathematics is called a corollary. 

" Again, there is a possibility of prenatal infection from 
either parent, previously referred to, which would be quite 
a different matter from constitutional heredity." This is 
the same old story of the germ theorist. Infection without 
a soil. How could there be " prenatal infection ?" Can a 
plant grow without a soil? If there be growth there must 
be soil — ask any biologist. If there be prenatal soil, this is 
heredity — the condition of growth. 

We now give the algebra of the germ theorist. We 
wish to be strictly fair. 

a = Health. 

b = The tubercle bacilli. 

c = Tuberculosis. 

The formula reads as follows : 

a -|- b = c. 

Let us examine. Mr. B., what is your age? Twenty- 
five. Are you in perfect health? Never better; just took 
out a policy for twenty thousand dollars ; examined by three 
physicians and all say first-class risk. Please step this way 
one moment, Mr. B., I want to examine your sputum. A 
microscopical examination is made. Tubercle bacilli are 
found. Mr. B., did you eat butter for breakfast? Yes, sir. 
Please examine the butter. Tubercle bacilli are found. 



—199— 

Mr. B., where have you been this morning? Walking in 
the open air. Please examine the air. Tubercle bacilli are' 
found. Let us examine the formula : 

a + b = c. 
i. e., health -f- tubercle bacilli = tuberculosis. (Mathematics 
don't lie.) This man has got tuberculosis. Bring in tuber- 
culin and let us make a test. If there be a reaction he has 
got the disease without doubt. Tuberculin confirms. 

Ladies and gentlemen of the medical profession, this is 
medical science as taught today. Millions of our fellow- 
beings are hastening to eternity. Is it not time to call a 
halt? 

Let us proceed. " It is true that either of these forms 
of transmission of the disease given would be in one sense 
a hereditary transmission, but k would be transmission of 
infective material, not of actual disease nor of diathesis. 
The difference may at first sight appear to be hair-splitting, 
but, in fact, this difference is of fundamental importance," 
etc. 

The above is rather a singular statement. Please ob- 
serve — it is hereditary transmission, yet it is not hereditary 
transmission. It seems like hair splitting, yet it is of fun- 
damental importance. To the writer it appears like — it 
either rains or it don't rain, for it is very evident if it don't 
rain it must rain. 

We now open a field for controversy. " Because there 
can be no hope of overcoming this dread scourge until the 
fatalistic idea that it is a constitutional disease can be dis- 
placed by a clear conception of its contagious character." 
The writer thinks that if we wait until " the fatalistic idea 
that it is a constitutional disease can be displaced " we will 
wait until Mother Earth lays by for repairs and receives a 
new axle-tree. In our judgment the constitutional will re- 
main. But we leave this for the future to determine and 
talk of other things at this time. 

If the view herein be clearly understood or correctly 
interpreted, it is seen an attempt is made to show a law in 
tuberculosis — an inviolable law ; that heredity is a factor 



—200— 

aiding this law in an extension of the disease ; that all dis- 
ease of this nature of whatever character is governed by 
this law. 

THE LAW OF SUSPENSION. 

The first stage in each case of tuberculosis is one of 
suspension. This creates a condition of tissue which al- 
lows the growth of tubercle bacilli. The tubercle bacilli do 
not cause the disease, but in many cases render it more fatal 
— fatal in that they cannot be removed — as a rule, they con- 
tinue to grow; fatal in that their growth consumes the air 
which should be taken up by the system; fatal in that their 
growth renders the lung tissue incapable of perfect aera- 
tion, etc. 

If in the stage of suspension before a growth takes 
place or while there is yet a feeble growth, perfect aeration 
be established or re-established — according to this law — the 
disease disappears and health is restored. In other words, 
if a perfect being — meaning by this one free from heredity 
as a factor — maintain a perfect aeration there can be no 
tuberculosis. Tuberculosis is, therefore, a disease of ill- 
ventilation or imperfect aeration. What, then, is the alge- 
braic formula for tuberculosis in the various stages of the 
disease ? 

a = Health. 

b = Suspension. 

c = Heredity. 

d = The tubercle bacilli. 

e = Tuberculosis. 

e' = more fatal. 

e" = most fatal. 

a -\- b = e (formula 1) 
i. e., health with suspension added means tuberculosis. 
Or transpose b : 

a = e — b (formula 2) 
i. e. s health is suspension taken away from tuberculosis. 

a -f- b + c = e' (formula 3) 
i. e.j health with suspension and heredity is tuberculosis of 
a more fatal type. 



—201— 

a + t> + c +d = e" (formula 4). 
i. e.j health with suspension, heredity and the tubercle ba- 
cilli added means tuberculosis of the most fatal character. 
This, the writer thinks, is the mathematics of tubercu- 
losis. Other formulas can be given — 

a + t> + c = e ' ( formula 3 ) . 
Transpose b -f- c. 

a = e' — b — c, but a = e — b (formula 2). 
Things equal to the same thing are equal to each other. 
Therefore — 

e — b = e' — b — c cancelling e — e' — c (formula 5). 
i. e., tuberculosis is rendered less fatal by the removal of 
heredity. 



-202— 



THE NECESSITY OF A MORE PERFECT AERATION. 



We are told in Genesis the Lord formed man of the 
dust of the ground, breathed into his nostrils the breath of 
life and he became a living soul. Whatever the belief as to 
the genetic account of creation, this much is certain : In 
the race of life man excels. The swallow of today is the 
swallow of the first century. The lion and tiger eat the 
same food and procure it in the same w r ay. Not so with 
man. He alone of all animate creation has shown wisdom 
and skill in environment. 

We rightly feel proud of this, yet there is reason for 
humility. 

To him who reflects and compares man's estate with 
the domestic mammal, it is evident : 

1st. The number of still-born to man is vastly in ex- 
cess to the mammalia. 

2d. The number of deformed or abnormal births to 
man is vastly in excess to the mammalia. 

3d. Of normal births to man, the number who die 
natural deaths before maturity is vastly in excess to the 
mammalia. 

If, then, the writer observes correctly, man presents the 
majority of still-born, deformed and of premature deaths. 
Should the comparison be made with the wild mammal the 
divergence is more marked. 

The conclusion follows : Man with a living soul, or in 
the exercise of reason, shows physical deterioration. 

Per contra, the animal without soul or reason has 
physically held its own. If true, these statements are 
worthy our careful consideration. Let us try to consider 
comprehensively and wisely. 

The word childhood is used as the period from concep- 



—203— 

tion to maturity. This, as will be seen, is the word in its 
most comprehensive sense. 

At conception the factors that enter the life of the em- 
bryo are largely the health and vigor of the parents. The 
purity of blood, strength of organism, predisposition, etc., 
all must enter. 

During gestation the blood of the mother is the blood 
of the fetus. The life and health of the fetus is the life and 
health of the mother. This follows of necessity. From 
birth to maturity the life and growth of the child is mainly 
of his own volition, assuming there be proper food and care. 

If at conception the blood of one or both parents be 
impure, if during gestation the blood of the mother be im 
pure, if after birth the environment or food of the child be 
improper so as to render its blood continuously impure — we 
have the condition of impure blood from conception to ma- 
turity or for the entire period of childhood. Nor is the 
condition shown an anomalous one among the civilized. 

Multitudes of such cases are seen in every generation. 
Being so common and so easily recognized the only wonder 
is that its true value is not duly weighed. 

For illustration : Should impure food be given the 
mother during gestation, or to the child during infancy, it 
is readily seen the health is soon impaired. It is impaired 
through impure blood. We have spoken of this elsewheie. 

But improper food is not the only means of blood im- 
pairment. There are many other ways. One of the most 
prevalent is non-oxygenation. In other words, improper 
ventilation of the blood as it flows in the life current leads to 
its impurity. It leads to its impurity in two ways. 

1st. The venous blood needs oxygen to change to 
arterial. 

Venous blood must not circulate in the arteries. 
Venous blood is impure blood and oxygen alone restores its 
purity. 

2d. The chyle poured into the venous current needs 
oxygen to complete its elaboration or formation into blood. 



—204— 

Chyle must not circulate in the arteries. Chyle is imper- 
fect blood and oxygen alone completes its perfection. 

In defective aeration we have these two faults : An 
arterial blood containing venous blood from the veins and 
chyle from the lacteals. What is the result? The subject 
whose life depends on such blood becomes physicially weak. 
The age of the subject makes no difference as to the fact of 
impurity — only as to power of resistance. 

The fetus in utero, the infant in arms, the child in the 
home are all subject to like influence. A fetus in utero 
may absolutely be killed by impurity of the mother's blood. 
Likewise an infant in arms or a child in the home in so far 
as they have the same powers of resistance. These facts 
are worthy of notice and must be taken into account in the 
consideration of the dread disease tuberculosis of which we 
speak later on. 

We said one who receives such blood becomes physi- 
cally weak. In what way? He is improperly nourished 
and a foreign element in his blood must of necessity act as 
an irritant. Let me illustrate. Suppose a healthy individ- 
ual eats food that is indigestible and that does not contain a 
requisite amount of nourishment. He may partake of tiie 
food as often as he please but his system constantly grows 
weaker. Will any one ask how he may become strong? 
So in imperfect oxygenation. The blood contains an irri- 
tant and does not contain a requisite nourishment. The 
subject constantly grows weaker. He may become strong 
by a change of aeration. In the adult this change should 
take place. The adult has reason for a guide. Not so with 
the child. The fetus in utero, the infant in arms has no 
such monitor. He is subject to the whim or caprice, as it 
may be, of another. During the infant's minority his life 
and well-being are but as clay in the hands of a potter — 
moulded at his will. Should this potter be an ignorant 
crank the child must everlastingly suffer. 

Such is the condition or history of thousands in our 
land. These waifs who come into existence without thought 
or care on the part of the parents become the future men and 



—205— 

women to populate and repopulate the country. Is there 
wonder at degeneration? Could it be otherwise? In this 
connection the question may be asked, does not nature make 
an effort to reclaim her own ? True, nature makes an effort 
to secure more oxygen by a hurried respiration in the child, 
and in a measure and in some instances secures it. Many 
times it is like the one who tries to gain strength by eating 
food more often. 

If the nourishment be not in the food the rapid eating 
does no good. So in aeration. Rapidity of breathing only 
makes the irritant more apparent. It does not increase the 
amount of nourishment. While this is true in regard to the 
child, it does not apply to the fetus. The fetus has no res- 
piration of its own. The oxygen of the fetus is from the 
mother's blood. If the blood of the mother contain but 
little oxygen, the fetus can secure but little and vice versa. 

The mother, then, during gestation, has it in her power 
to give or withhold oxygen. Does she in every case clearly 
understand this? If so, does she so act? 

Thus it is seen that the child or fetus is hedged in, in a 
peculiar way in regard to an essential of existence. The 
mother wrongs her offspring through ignorance. The off- 
spring must suffer the wrong through an inability to rectify. 
Since civilization began it has been so, and so it must re- 
main until by a clear recognition of facts we change the 
conditions. Should a child be denied food the public at 
once cries out. The wrong must be righted. Should an 
imbecile be born in the home the state provides for its care. 
Should a child become wayward reformatories are at hand. 
Should a child be still-born — from want of oxygen — no man 
in the land has courage to raise his voice. " God moves in 
a mysterious way, His wonders to perform. He plants His 
footsteps in the sea and rides upon the storm." Thus the 
major part of the deaths in childhood are providentially ex- 
plained. How consoling to the bereaved, " The Lord has 
given, the Lord has taken away, blessed be the name of the 
Lord." This, it seems to the writer, is a perversion of 



—206— 

Scripture in the present instance. But there are other per- 
versions. 

We stated that during gestation the mother has power 
to give or withhold oxygen from the fetus. In health this 
is true. In disease, more particularly of the lungs, this 
statement should be modified. A woman who has diseased 
lungs marries. The disease is so extensive it is difficult for 
her to properly aerate her blood. The field for aeration is 
so small. She becomes pregnant. A double work must 
now be done. Not only must she aerate the blood for her- 
self, but also for the fetus. If the field were formerly 
small, how is it now? Either the mother or the child, or 
more commonly, both must suffer. 

It seems to the writer that one who maintains heredity 
is not a factor in the transmission of disease, does not clearly 
understand the situation. 

Heredity is a factor not only in the transmission of sim- 
ilarities, but also in disease itself wherever aeration of the 
blood is concerned. It must be true. So that whatever 
the view as to the intermarriage of consumptives — weak 
lungs beget weak lungs and weak lungs beget an infant 
with imperfect aeration of the blood — the primary step in 
the advancement of tuberculosis. Without this primary 
step the disease is unknown. 

In corroboration of what has already been stated we 
herewith present the following typical cases : 

Case 1. Mrs. G., set. about 37 — in good health — has 
had two confinements. On both occasions her children 
were weak and purple in color on delivery. For several 
weeks prior to confinement she staid closely in the home and 
took but little exercise. Her husband is several years her 
senior and is in poor health. At the third pregnancy — her 
last, I was notified of the above facts and ordered light 
exercise during the last weeks and small doses of chlorate of 
potassium three times a day. Child was more vigorous 
and less purple. 

The ages of the children range about two years apart 
and the following is the present history twenty years later : 



—207— 

The eldest is delicate, but is able to act as a clerk in a 
dry goods store. The second died at nine or ten years of 
age of asthenia. The third is now about twenty — the pic- 
ture of health — and graduates the coming season. 

The writer thinks a supply of oxygen during intra- 
uterine life has done thus much for him. 

Case 2. Mrs. S., set. about 30, in delicate health and 
has weak lungs. Has had three confinements. The chil- 
dren's ages range as follows : Between the eldest and second, 
four years. Between the second and third, two years. 

During gestation of second child the mother's health 
is unusually poor ; indigestion, cough and abscesses on va- 
rious parts of the body. At confinement instrumental deliv- 
ery is used owing to the size of the child — ten and one-half 
pounds. The father's health is good. Soon after the birth 
of this child it is observed the breathing is rapid and at 
times irregular. The child is fretful and nervous and sel- 
dom gives the mother a full night's rest. Every tooth a 
pang, every cold a burden. Treatment is instituted early, 
but is of little avail. Continued on these lines for upwards 
of two years. Dr. W., Sr., of R , one of the best phy- 
sicians of Northern Ohio, is called in consultation and after 
a careful examination, said, " It is my firm belief this child 
cannot be reared." 

What is the treatment henceforth? A walk or run 
around the house once or twice each morning after being 
dressed. Result : The child begins to improve and contin- 
ues to do so until he wants to be out of doors the entire 
time. Fourteen years have elapsed. 

AYhat is the present status at nearly sixteen years of 
age? Last year this boy was captain of a foot ball team 
that won in nearly every encounter, and this year he throws 
the sixteen pound iron ball in a forthcoming athletic contest. 
Other cases could be given. In the face of these truths, who 
can deny the value of a more perfect aeration? 

Dr. F. N. Otis, in his classical work on " Genito-Uri- 
nary Diseases," '83, says in substance as follows: In gonor- 
rhoea, if the purulent discharge come in contact with a 



—208— 

healthy mucous membrane it causes the disease. He further 
adds, this is not true of syphilis. In this disease there 
must be contact and also an abraded mucous surface. The 
writer has long held and yet maintains that a healthy or 
abraded mucous surface and the contact of the living tu- 
bercle bacillus does not constitute tuberculosis. There must 
be something more, viz. : The precedent state. Without 
this state there can be no transference of the disease or con- 
tagion. With this state the disease is readily transferred 
in the conditions named. 

Herein is a radical difference of belief which must be 
settled before a clear light can be diffused. Let us endeavor 
to make this still more plain. Dr. Russell says — we quote 
his writings for they have been scattered over the land by 
the Health Boards in various parts of the country — Dr. 
Russell says : " The tubercle bacillus, not being inherited, but 
passing into the body from the outside, how does it get 
there ? Under what conditions does it pass from the outside 
to the inside of the body? Under what conditions does it 
live and propagate there ? It is impossible to demarcate the 
answers to these questions as clearly as the questions them- 
selves.'"— (Dr. Jas. B. Russell, B. A., M. D., LL. D., Senior 
Medical Officer of Health, Glasgow. Republished by per- 
mission by the State Board of Health of Massachusetts, 
1896.) 

The writer answers , these questions briefly. The 
tubercle bacillus gets there by simply growing in a soil pre- 
pared. It passes and grows under the conditions of suspen- 
sion of atmospheric influence. It lives and propagates under 
the same conditions of suspension. In other words, if there 
be imperfect aeration of the blood from any cause and for 
any length of time, all the conditions named will be found. 
On the accuracy of this statement the writer pledges his 
ideal reputation and challenges controversy. What greater 
assurance can be asked? We read in current medical liter- 
ature that of the births in Massachusetts fifty per cent die 
before they are fifteen years of age. The deaths are largely 
due to tuberculosis. How sad a commentary on present 



—209— 

civilization ! The burden of rearing children is prior to fif- 
teen. This burden falls largely and heavily on the elder part 
of every community, the part that practically needs sup- 
port. Think of it ! A child who has grown to near matur- 
ity and is educated to a point of self-support is ruthlessly 
taken away. Can this condition be averted? 

After twenty years of close study and accurate re- 
search the writer answers this question in the affirmative. 

Give us the method at once. By legal restraint in mar- 
riage, by careful watching of the mother during gestation, 
by physical culture in the child, by accurate ventilation in 
the home and elsewhere, in a word, by a perfect aeration 
thousands of these youths may be annually rescued to years 
of usefulness. Is it worth the labor? The writer thinks 
it is. 

In conclusion, with due deference to education, do not 
tie yourself too closely to the germ theory of tuberculosis, 
for rest assured in the near future it will be shown that 
germs have little value. 

Tuberculosis is a constitutional disease, induced by im- 
perfect aeration, is based on law and can be controlled. 

The mathematics of the situation is as follows : The 
death rate from tuberculosis is in direct ratio to abeyance of 
atmospheric influence. 



—210— 



THEORY OF THE PRODUCTION OF TUBERCULOSIS. 



DES DEUTSCHEN VATERLAND. 

"Was ist des Deutschen Vaterland? 
Ist's Preuszenland, ist's Schwabenland ? 
Ist's wo am Rhein die Rebe blukt? 
Ist's wo am Belt die Move zieht? 

O nein ! Nein ! Nein ! 
Sein Vaterland musz groszer sein. 
* * * 

"Das ist des Deutschen Vaterland 
Wo Eide schwort der Druck der Hand, 
Wo Treue hell vom Auge blitzt, 
Und Liebe warm in Herzen sitzt, 

Das soil es sein! 
Das, wackrer Deutscher, nenne dein ! 

"Das Ganze Deucsthland soil es sein ! 
O Gott! von Himmel sich darein! 
Und Gieb uns rechten deutschen Muth, 
Das wir es lieben treu and gut ! 

Das soil es sein ! 
Das Ganze Deutschland soil es sein." 

We have elsewhere stated, and again affirm, tuberculo- 
sis is a constitutional disease dependent largely on the evils 
of civilization and governed by the following law : The 
death rate from tuberculosis is in direct ratio to abeyance of 
atmospheric influence. Suspension of atmospheric influ- 
ence is, then, the primary cause of tuberculosis, not the 
germ tubercle bacillus, as commonly believed. 

In a former article we attempted to show that deep 
breathing, in so far as it removes suspension, removes the 
primary cause in the same ratio, and is thereby curative. 
We now try to set forth more clearly the true cause or na- 
ture of this most serious disease, and in so doing to give as 
best we may our theory of its production. 



—211— 

In the first place, please bear in mind that tuberculosis 
is a constitutional disease. Medical writers of this genera- 
tion are somewhat at variance on this important topic. 
Some classify the disease as constitutional and then define as 
local and infectious ; this seems contradictory. Others be- 
lieve it a specific infectious disease, yet fail to state the con- 
dition under which the infective germ or cause enters. This 
essential is omitted — an unwarrantable fault. Still others 
recognize a condition or state of the system as necessary for 
its natural transfer ; but boldly assert this condition or state 
cannot be named. The fallacy of this position is shown in 
" Tubercular Annotations." 

Nor is the diversity of belief confined to this alone. It 
is just as great on the question of heredity in tuberculosis. 
Ask the eminent German medical scientist of today if scrof- 
ulosis and tuberculosis be one and the same, and he will an- 
swer yes. In the same breath he will affirm heredity is a 
factor in scrofulosis, but not a factor in tuberculosis. Such 
teaching is illogical, and, we think, immoral. The emi- 
nence of the teacher ofttimes blinds the intellect. Let us 
endeavor to use logic and truth at the same time. If scrof- 
ulosis and tuberculosis be identical they are identical in 
transmission. The writer claims tuberculosis a constitu- 
tional disease — constitutional from the moment of inception , 
that scrofulosis and tuberculosis are not only alike in nature 
and manner of inception, but also alike in transmission. 

The time has come for medical men to assert with posi- 
tive earnestness that which they know. The air is full of 
skepticism and unbelief. The medical world is running 
wild after the sheerest fads. 

Do I speak the exact truth in saying the scientist is 
largely to blame? It is time, high time, to utter truths and 
stand by them in argument. What the world wants more 
than all else is men, high-minded men, who, knowing what 
is right, dare assert and maintain the same. The medical 
policy for the last few decades has been one of vacillation 
and inaptitude. In no line of work is this more clearly seen 
than in the management of tuberculosis ! The land of sci- 



—212— 

ence, germs and serums shows its ravages most clearly. 
When will we control? 

These and kindred topics could be presented indefinitely. 
Why prolong the discussion? It is not that we wish to 
demolish the structure that has been reared with so much 
painstaking, but rather to notify the residents of danger. 
The foundation is unstable. The building will ultimately 
be removed and rebuilt with greater care. At present we 
are reprehensible if we do not notify. 

It was an ancient belief that the life of the animal is in 
the blood. There is much in this statement to meet accept- 
ance and commendation. As the blood deteriorates the 
health declines ; as the blood flows out the life departs. 
There is a health standard, so that, as a rule, show the char- 
acter or composition of the blood and the stamina or vitality 
of the individual is seen. 

Much may be said in extenuation of this belief. Yet 
on reflection it is seen many things must enter in the com- 
position of the blood; or, perhaps better, many factors are 
essential in the production or formation of the blood in its 
perfection. We enumerate some of the more important. 
As a rule, the richness of the blood depends on the quality 
of the food. The quantity of food determines more the 
amount of blood. Yet there are exceptions. A rich food 
may secure a large blood supply or a plain food a rich sup- 
ply. There is something strange in this provision of nature. 
Each animal seems to adapt itself to the food ingested. We 
see well-nourished people who live on plain food and illy- 
nourished people who live on rich food. The richness or 
plainness of the food does not always alone determine the 
quality of the blood. Other factors enter in its production. 

One of these is digestion. It is not alone the quality or 
amount of food ingested, but the amount digested, that goes 
to restore an impoverished blood. At all ages a constant 
waste is going on in the system. In youth there must be 
also a supply for growth. This waste and supply must be 
met. It is met by ingestion and digestion of food. But 
digested food is not blood. Before it becomes blood it must 



—213— 

be taken up and poured into the proper channel, conveyed 
to the lungs and aerated. It is then blood, and can be used 
or utilized by the system in its growth or development. 
This seems very simple, but the latter, or aeration, has ap- 
parently been ignored by many of the profession. 

Today there are leading lights in practice who prefer 
to call in a miscroscopic germ to account for a faulty aera- 
tion. To the writer this seems absolutely silly. Germs do 
not naturally grow in healthy tissue. Imperfect aeration 
prepares the soil for the so-called germ of tuberculosis. 
Change the aeration in this early stage and there is no tuber- 
culosis, or, if you prefer — germ growth. This is certainly 
worth knowing. 

But is not the idea of germ growth recent medical 
science? Is not the germ theory adopted by all scholars of 
eminence ? Can we set aside so great an array of evidence ? 
What would be the ultimate outcome should we discard the 
germ theory of tuberculosis ? Would we not again go back 
to our forefathers and start anew ? In reply to this we ask, 
what would the world miss today should all knowledge of 
tubercle bacilli be cast into everlasting disuse? The writer 
speaks candidly and upon reflection when he asserts the 
germicidal or serum treatment of tuberculosis is no better 
than former treatment. If modern treatment is of no avail, 
why should we cling to it with so death-like a pertinacity? 
Echo answers, why? It should ever be the aim of the 
scholar to learn to unlearn what has been learned amiss. 
We have been learning amiss. Let us correct the error and 
mend our way. 

Two theories, in particular, have been held in the past 
as explaining the presence of tuberculosis. Let us consider 
these for a moment: 

1. Altered condition of blood originating in a perver- 
sion of nutrition, or tubercle, an exudation. 

2. Increased cell development and multiplication of 
the included nuclei, or tubercle, a new growth. 

The second or cell growth was held by the world-re- 
nowned Virchow, but repeated investigations by careful 



—214— 

histologists have failed to find said growth. The support- 
ers of this theory have therefore been few. 

The perverted nutrition as found in the first theory is 
said to be owing to many causes, viz., vitiated air, imperfect 
assimilation, hereditary taint, etc. 

Please notice that vitiated air, imperfect assimilation, 
hereditary taint, etc., bring in a large field of disease. It 
seems to the writer that when so many causes are assigned 
as producing one and the same thing, viz., tuberculosis, we 
should carefully scrutinize, for such occurrences are rare. 
It is something as with the vender of medicine who has a 
remedy for the nomenclature of disease. One is apt to be 
suspicious of its intrinsic worth. 

The writer believes faulty or imperfect aeration pro- 
duces an altered condition of the blood. It is altered, first, 
in that the venous blood is not properly xhanged to arterial ; 
second, in that the chyle is not properly transformed into 
blood corpuscles. This blood flowing to every part of the 
system causes or induces the constitutional disease known 
as tuberculosis. For mark, as already stated, tuberculosis 
is never a local disease. 

(a) Vitiated air may produce this same condition of 
blood or system. 

(b) Heredity may allow this faulty aeration or condi- 
tion of the blood. 

(c) Imperfect assimilation, etc., etc., we think have 
nothing to do with the condition named. 

We also take the liberty at this time to state that what- 
ever destroys or hastily eliminates the red corpuscles re- 
maining in the system hastens the progress of the disease, as 
child bearing, excessive venery, etc. The reason is ob- 
vious. Perfect blood is being formed slowly. The hasty 
destruction of red corpuscles from any cause leaves the sys- 
tem in a state of famine, which is slowly overcome. It is in 
this state the tubercle bacilli naturally enter the system and 
grow. I ask any fair-minded and candid man, do they cause 
the disease? Is not the soil prepared before the vegetation 
takes root? If so, should we control the soil do we not 



—215— 

control the disease? Herein lies the secret of the control 
of tuberculosis. Herein lies the secret of the ameliorated 
condition of mankind during the last decade. Our life has 
afforded a better aeration of the blood. Afford a still bet- 
ter aeration and the disease tuberculosis is more fully con- 
trolled. Can we control perfectly? Knowledge in this in- 
stance is power. Power gained in an avenue of life means 
greater insight in future trials. Let us take courage and 
press steadily on. 

The question may be asked, what change takes place 
in perfect aeration. It is known in the change of venous 
blood to arterial, the dark red becomes a bright red. Gray, 
the anatomist, tells us this change is due to the oxygena- 
tion of the iron in the blood. Spectrum analysis shows 
this. In regard to the change that takes place in the chyle 
in the formation of red corpuscles we have little definite 
information. It is thought at present the white corpuscles 
are formed in the lymph ducts or glands, while the red are 
formed direct from the chyle. Certain it is, chyle is not 
blood ; certain it is the fluid is still chyle when it enters the 
venous circulation. Passing directly to the lungs, it leaves 
them as blood. The change or conformation takes place 
during aeration. In the absence of further light we assume 
aeration changes chyle to blood. It is when an imperfect 
blood is formed, or, in other words, it is when there is an 
imperfect aeration, that the bacilli take root and grow. 
The imperfect aeration in every instance precedes the vege- 
table growth, or the soil precedes the growing plant. The 
vegetable growth, then, may modify the disease, but is not 
the cause of it. 

The construction of the thoracic duct in being single, 
while many organs are placed in pairs ; the plan of dis- 
charge, in that it commonly empties its contents into the left 
vein and not into the right, or both, are among the anatomi- 
cal peculiarities of this alone. The commingling of the 
chyle with blood already devitalized and with the bulk of the 
body's lymph ; the passing of the united stream to the lungs 
to combine with the oxygen of the air, shows a wisdom of 



—216— 

construction seldom seen. The exact change that takes 
place is not known, but the combined stream continually 
flowing gives life and vitality to the whole organism. We 
feel assured that when any change occurs in this current 
either by man's device or folly, the entire system must suf- 
fer. It is no local disease. In point of fact, this is what 
is seen in surgery. Remove a tuberculous mass from any 
part of the body — does the wound heal readily ? Is the dis- 
ability removed entire? In no case is this true — plain evi- 
dence to the writer that tuberculosis is not a local disease. 
Treat the subject constitutionally; give him, in so far as 
possible, a perfect aeration of the blood, and I pledge you 
the patient in every case will receive a benefit. 

It is these little things which tell us plainly the law of 
tuberculosis must be true. 



—217— 



INTROSPECTION. 



By introspection or the introspective method is meant 
the studying of mental phenomena by means of one's own 
consciousness. Everything about us or within is a subject 
of consciousness. We are conscious of one's presence or 
absence, of an opinion or belief, etc. We study or grasp in 
its entirety as we lay hold of the mental phenomena con- 
nected therewith. So that the introspective method pre- 
supposes a rational being in its exercise. Mind is neces- 
sary to reason. 

The introspective method is used at this time not so 
much to look into or examine the individual as to search 
out or investigate theory. Medicine is full of theory — 
theory as to cause, prevention and cure of disease. Some 
are true, many are false. The wise physician discriminates. 
He distinguishes the true from the false. How better to do 
this than by the exercise of reason in the introspective 
method ? 

Today we have a theory of the disease tuberculosis. 
On what is it based? Evidently, not on reason or analogy. 
It is based exclusively on microscopical examination. Cer- 
tain microscopic organisms are found in certain locations 
at certain stages of the disease tuberculosis. These are 
assumed to be the direct cause. The writer thinks this 
wrong. He has his reasons for so believing. Microscopic 
organisms do not naturally grow in health or induce disease. 

(a) Microscopic organisms, like all plant life, grow 
where the soil is properly prepared. 

(b) The preparation of the soil, in every case, precedes 
the growing plant. 

(c) The soil is, then, the first stage or cause of tuber- 
culosis. 

How is a soil prepared? By suspension of atmospheric 



—218— 

influence. What does suspension of atmospheric influence 
induce? A faulty aeration or impure blood. What are 
common methods of suspension? 

(a) Heredity, in that an imperfect lung tissue aerates 
the blood in an imperfect manner. 

(b) 111 ventilation, in that an impure or impoverished 
atmosphere fails to furnish the requisite amount of oxygen. 

(c) Occupation, in that there is a mechanical obstruc- 
tion to aeration. 

In these and other ways a soil is prepared in the indi- 
vidual which allows the entrance of the growing bacillus, or 
so-called cause of tuberculosis. This growth, if cause at all, 
as already shown, must be a secondary one. 

Based on the same assumption is a theory of the pre- 
vention of tuberculosis. If the tubercle bacillus be the pri- 
mary cause of tuberculosis, and all germ theorists believe 
this, the prevention of the disease in theory is very simple. 
It is simply to prevent the entrance of the growing germ. 

In practice prevention is found a very different matter.. 
In truth, the germ naturally enters the system and grows 
without the rational aid of man. To prevent its entrance 
and growth, or in other words, to prevent tuberculosis where 
there is a favorable soil, according to present notions, is not 
in the power of man. Prevention of tuberculosis is, then, 
practically a dead letter. 

Look around you and see if this be not true. The eyes 
of the profession are slowly opening. Give us more light! 

Based on this assumption, that tuberculosis is a specific 
infectious disease is a theory of treatment. In the writer's 
judgment, in no phase of medical literature is common 
sense and intellect more perfectly held in abeyance. 

(a) Tuberculosis is caused by the tubercle bacillus. 

(b) The bacillus, in growing in the healthy system, 
gives out or throws off ptomaines, leucomaines, etc., which 
poison and ultimately destroy. 

(c) The extract of these same bacilli, grown under 
other circumstances, injected into the diseased system pre- 
vents their normal action or is curative. Wondrous thought ! 



—219— 

Suppose you give a healthy man an ordinary dose of strych- 
nine. Suppose your neighbor practitioner injects another 
ordinary dose. Is there a sane man in the universe who will 
argue that one dose counteracts the other? The germ theor- 
ist has been teaching this the last two decades. Ladies and 
gentlemen of the medical profession, are we professional 
thinkers or are we incorrigible asses? 

On the same line of assumption is the theory of immun- 
ity. To claim in one breath that a plant growth throws out a 
poison which causes a disease and in the next to claim the 
same poison injected secures an immunity! Rationally con- 
sidered, how could one and the same poison both cause and 
prevent a disease ? What shameless folly ! But, in this 
case, we leave out reason entirely, and ask : Does it do it? 

We stated suspension of atmospheric influence causes 
an imperfect aeration or impure blood. That this condition 
is found in all cases of tuberculosis we candidly affirm. 
That others now recognize this truth is plainly shown. Prof. 
Osier says : " The arrest or cure of tuberculosis is a ques- 
tion of nutrition entirely, and that the essential factor is to 
improve the resisting forces of the body so that the disease 
cannot make further progress or is eradicated. Fresh air 
and good food are the most important means by which 
the nutrition may be increased/' (Maryland Medical Jour- 
nal.) Please remember these are the words of a renowned 
germ theorist. Please note Prof. Osier claims tuberculosis 
a specific infectious disease, yet treats it as a constitutional 
one. The writer claims tuberculosis a constitutional disease, 
based on law, and treats it as such. Which is the more 
consistent ? We leave this to others. 

But mark, there is something of more practical worth 
to the living than the treatment of tuberculosis. Need I say 
prevention? So soon as Ave clearly understand the cause of 
disease so soon are we able to see clearly a method to pre- 
vent the same. disease. So long as we teach one thing and 
practice another so long the great mass of the world's peo- 
ple will remain in blissful ignorance. 



—220— 

By a proper use of the introspective method we may not 
only examine our own theories, but those of others, and the 
world is thereby made wiser. 



—221— 



INCIPIENT TUBERCULOSIS. 



' The forces of the universe are in league against a lie." 
— Emerson. 

Definition: A constitutional disease dependent largely 
on the evils of civilization, and governed by the following 
law : The death rate from tuberculosis is in direct ratio to 
suspension of atmospheric influence. 

Speculation has been rife whether tuberculosis is trans- 
mitted. Some have said yes, others no, and a vast host of 
the profession are as yet undecided. 

That the author's statement appear not biased, con- 
temporaneous writers are quoted: 

" Consumption is caused by a germ known as the 
tubercle bacillus, etc. This germ is not inherited, but is al- 
ways contracted from some other case," etc. (State Board 
of Health of New Hampshire.) 

This statement, coming from so high a source, has the 
merit of being definite. There is only one fault we at pres- 
ent observe, viz., the forces of the universe are in league 
against it. 

" It is an admitted fact that no child is born with tuber- 
culosis, yet they do inherit that peculiar, lymphatic, ansemic, 
poorly-nourished constitution which gives them but little or 
no resistance when exposed," etc. (Jas. A. Burroughs 
M.D.) 

" In 1861 I attended a phthisical woman in her first 
confinement. She belonged to a consumptive family, had 
suffered herself before she got married, and died in the third 
week after confinement. The fetus was born at the end of 
the seventh month of utero-gestation, and lived a few min- 
utes only. There were numerous gray military tubercles in 
the tissue of the liver near the surface, a few in its perito- 
neal covering and the spleen, and on the pulmonary pleura." 
(A. Jacobi.) 



—222— 

Please observe, the one says " No child is born with 
tuberculosis " ; the other says " I have seen tuberculosis in a 
seven months' fetus." Does the fetus invariably die be- 
fore viability? If not, of what value is the "admitted 
fact?" 

The truth is, many children are born " with that pecu- 
liar, lymphatic, anaemic, poorly-nourished constitution," but 
only a proportion of them have tuberculosis. Why not all ? 
To the writer the reason seems plain. The proportion who 
take the disease, in some way, have suspension of atmos- 
pheric influence; the others do not have said suspension. 

" The prevention of tuberculosis by prohibition of mar- 
riage of consumptives will remain an Utopia until human 
nature changes and the reason exerts a greater influence in 
such matters than the emotions." (St. Louis Medical Re- 
view. ) 

If we clearly apprehend, there is a brighter future for 
humanity when reason has full sway. In other words, mar- 
riage can be regulated to diminish tuberculosis. This, if 
true, should be clearly understood by all. The minister, jus- 
tice and judge alike need enlightenment. 

" Tuberculosis unquestionably may be inherited, but in 
what way and how often are unsettled problems." (Osier's 
Practice.) 

The writer, in his weak way, attempts to render mat- 
ters more clear and simple. In order to do so the germ the- 
orist is taken on his own ground. It is said tuberculosis is 
due to a germ, or rather tuberculosis is germ growth in the 
system. The writer thinks differently. He believes tuber- 
culosis is an induced state or condition under control, and 
germ growth simply secondary. His reasons for so believ- 
ing are as follows : No plant life can take root and grow 
without a suitable soil. The tubercle bacillis is plant life. 
Therefore the tubercle bacillus, in growing, has a suitable 
soil. If found growing in one's system a suitable soil is 
found in said system ; otherwise it does not grow. No 
growing tubercle bacilli are found in a healthy organism. 

It is seen the soil must precede the plant growth. To 



003 

this rule or law there is no exception. Herein lies the fal- 
lacy of the germ theorist : He assumes the plan tubercle 
bacillus causes the disease tuberculosis because it is usually 
found in every typical case. 

As in creation primeval the sun came into existence 
before vegetation, so in tuberculosis suspension of atmos- 
pheric influence ever precedes the advent of the germ. 
Flood the earth with sunlight and vegetation at once starts. 
Suspend atmospheric influence in the individual and the 
same condition prevails — the germ grows. Withdraw all 
sunlight and vegetation ceases to exist. Sunlight to the 
earth's vegetation is as pure atmosphere to earth's people. 
Perfect ventilation means freedom from tuberculosis. The 
knowledge and application of this simple truth will rid us 
of the most deadly disease known to the human race. Is 
not such knowledge worthy attention? The writer so con- 
siders it. Let us proceed. 

Much time and labor have been spent in determining 
how the tubercle bacillus enters the circulation and grows in 
various parts of the body ; how the germ enters the mother's 
blood-current and by means of the fetal circulation is con- 
veyed to the fetus. By some this is thought to be truly 
marvelous. When the view entertained by the writer is 
closely examined he thinks the inexplicable is rendered more 
plain. The condition precedes the growth in every instance. 
It has been shown this must invariably be the case. A 
child or person has the condition or precedent state. It 
matters not for illustration how obtained — by heredity or 
suspension in the individual. He has the condition or soil. 
All that is requisite is the presence of the germ. These so- 
called germs are everywhere present. Is there anything 
mysterious in their growth? Yes, but the mystery is as 
the growth of a blade of grass or kernel of wheat. " Simply 
this and nothing more." 

At times much ado is made because certain meats con- 
tain tubercle bacilli. Has it ever entered the mind of the 
scientist that meats may be tuberculous in the absence of 
tubercle bacilli? The writer has the temerity to assert that 



—224— 

sometimes, though infrequent, this may be the case. Sup- 
pose these germs are thus found in said meat? Is there 
any general outcry when these same germs are found in the 
food we eat and the water we drink? If not, why not? 
Is not the major portion of our food and drink taken cold — 
or not sterilized — before eating? Are not our meats steril- 
ized in the cooking? " Consistency, thou art a jewel." 

Again, we are told so much about a " former case," as 
if no case of tuberculosis occurred unless there be a pre- 
ceding case in the same house or neighborhood. This seems 
absolutely silly. If tubercle bacilli cause the disease tuber- 
culosis ; if tubercle bacilli be everywhere present, what is 
the use to everlastingly harp on the " former case ?" 

If the germ truly causes the disease, and germs contin- 
ually float in the atmosphere, rationally considered one germ 
would cause the disease the same as the germs in a" former 
case." Hence, we have illustrated cases like the following: 

Mrs. K. is sixty years of age and has an infant grand- 
son living at her house. Mrs. K. has had a chronic cough 
for years. The grandson is losing flesh and having night 
sweats. He at times has a slight cough. After several 
weeks he dies. No autopsy. Physicians assert this little 
fellow had tuberculosis, and that he caught the disease from 
his grandmother. Are you satisfied with the inception of 
the disease? The writer claims a soil is first prepared. 
When prepared, the tubercle bacilli, from whatever source, 
readily grow. 

For a writer to assert that every extension of the dis- 
ease is due to a " former case " would be to assert that germs 
must be fresh in order to infect new victims, i. e. } the infec- 
tious material is carried with the fresh germ, or, in other 
words, is external to itself. No true germ theorist could 
accept this. We are therefore led to believe it is the germ 
alone that grows, but it grows in a soil already prepared. 
The germ does not prepare the soil. 

The fundamental principle involved is not how recent 
the germ, not from whence derived, but how is the soil pre- 
pared in which the germ thrives. Do we hold in our hands 



—225— 

the preparation of the soil ? Can we prevent its formation ? 
If answered in the affirmative, we can control tuberculosis. 

Take, for instance, the case presented by Dr. Jacobi. 
The mother is tuberculous, i. e., has suspension of atmos- 
pheric influence. The soil is prepared and tubercle bacilli 
are growing in her system. Like produces like. The fetus 
in utero has the soil of the mother. If bacilli grow in the 
mother they likewise grow in the child. They are thus 
growing when observed by Dr. Jacobi. 

Another mother is healthy. The fetus in utero is also 
healthy. While tubercle bacilli may be found in the tissue 
or blood of both mother and fetus, they are not found grow- 
ing in said systems. Why not? There is no soil, no sus- 
pension of atmospheric influence. Hence, freedom from 
tuberculosis. 

Another case presents. The father is in the last stage 
of tuberculosis — so feeble he is unable to walk but a few 
steps. His wife is in fairly good health and becomes preg- 
nant at this time. A miscarriage shows tubercular devel- 
opment in said fetus. How explained? It will at once be 
admitted this is an unusual method of transmission. Tu- 
berculosis usually descends from parent to child through the 
mother. Not always so. The father may also transmit the 
disease. All conditions must be favorable for this consum- 
mation. What are the conditions? The germ theorist ex- 
claims it is readily explained: "The seed of disease is in 
the semen of the father/' The writer asks : ' " My dear sir, 
or madam, how can a seed grow without a soil ? " True, the 
tubercle bacillus may be in the semen. It may also be in 
the blood of the mother or fetus. 

"Why does the so-called germ grow in the fetus? Let 
us attempt an answer. The mother, apparently, is in good 
health. She takes little or no exercise. What of this? 
Her very inactivity causes suspension of atmospheric influ- 
ence in herself and fetus, and allows the tubercle bacilli to 
grow. Hence, growth and consequent miscarriage. The 
same condition prevails if suspension occur in any other way. 

This, we think, a correct interpretation of facts. 



—226— 

After twenty-five years of active practice the writer 
recalls abortion and miscarriage enough times to recognize 
the certainty of heredity in tuberculosis. Knowing this, 
he thinks he has a clear idea of the inception of the disease. 



—227— 



AS OTHERS SEE US. 



" O wad some power the giftie gie us 
To see oursels as others see us ! 
It wad frae monie a blunder free us 
And foolish notion." — Burns. 

Colorado Springs, Col., August 27, 1898. 
Br. H. H. Spiers, Ravenna, O. 

Dear Doctor — Allow me to congratulate you on your 
article in the Medical Record, " The Control of Tuberculo- 
sis." I was much interested in the article and am in strong 
sympathy with you on many points mentioned in it. 

I cannot, however, entirely agree with you as to the 
fact that if a person is kept clean, takes daily exercise, in- 
hales pure air that such a person cannot develop tuberculo- 
sis if heredity is thrown out, as I have seen cases that ful- 
filled all these requirements to a most perfect degree and yet 
did develop tuberculosis, possibly through milk as a child, 
the germ lying dormant for years. 

I send you a reprint of some of my work. 

Yours truly, 

C. F. Gardiner. 

The above is one of many letters in our possession. It 

is difficult for us to answer or take note of all. 

In the first place, we ask no one to entirely agree with 
us. In truth, we do not expect this. The fact that one 
differs in some minor point is prima facie ' evidence he has 
ideas of his own. When one accepts ideas, style, language, 
etc., of another, and swallows it, however crude, it is marked 
evidence that person lacks individuality. We try to be broad 
ourselves and allow the same latitude to others. At the same 
time a law must not be set aside to attend minor details. 
The law should have precedence. 

We fear our able contemporary does not clearly com- 
prehend the nature of tuberculosis. We are led to believe 
this from the " reprint of work " sent us. The author seems 
to be grappling with the germ theory of this disease. Leave 



—228— 

the germ theory alone. Set it aside for the present and 
carefully examine the law of tuberculosis. What is tuber- 
culosis? A constitutional disease dependent largely on the 
evils of civilization, and governed by the following law : 
The death rate from tuberculosis is in direct ratio to sus- 
pension of atmospheric influence. 

Two things are noticeable: (a) Tuberculosis, is a con- 
stitutional disease; (b) tuberculosis is governed by law. 

In each of our articles we have endeavored to make 
these facts clear. The one quoted in the Medical Record is, 
we think, no exception. 

So that if our friend, Dr. Gardiner, fails to take in 
these truths he fails to properly appreciate our effort, though 
he congratulate. For this we feel sorry. 

The error of Dr. Gardiner is not uncommon. This 
mistake is seen on every hand. 

Why are we so dull of apprehension ? This is certainly 
un-American. Americans have perceptives and use them. 
Why so dull in this ? Two reasons can be readily assigned : 
(1) Education; (2) authority. 

In one sense it is true ; we believe what we are taught 
to believe. Europeans have saddled upon us a germ theory 
of tuberculosis. This theory is taught in the schools. We 
are educated in this belief. Germs there must be, for we can 
see them. Seeing is believing. Cause the disease they 
must, for they are found with the ailment. No further 
question need be asked. If one ask why these germs are 
found in certain conditions he is regarded an heretic. If 
one suggests there may be the condition in the absence of 
germs he is regarded as a lunatic. If one speak of the con- 
dition prior to the entrance of growing germs he is asked if 
he studied bacteriology in Heidelberg. Bacteriology and 
high-power microscopes are at a premium. Reason and 
common sense are excluded. 

Does the writer express a truth ? If so, is not this 
judgment manifestly unfair? Education — school learning — 
is one thing, and education — progression — another. The 
one is memorizing dry statistics ; the other the use of the 



—229— 

intellect in the higher sense. Which shall it be? 

Again, there is reverence of authority. A young fresh- 
man, on being asked what he thought of the professors in 
the school he was attending, replied : " They are foine men, 
but they have no hids." Now herein is a fault with many 
authorities : They have no " hids." A professor in medi- 
cine who sits down and deliberately compiles statistics week 
after week, then quotes them in his lectures as law and the 
gospel has no "hid." He may be pre-eminent in science ; 
he is only eminent in common sense. 

Can we improvise " hids " for them so situated? This 
is a question not only for the near future, but for all time. 

We travel in ruts. If one step from the beaten track 
he is regarded an heretic or lunatic. Yet mark, it is these 
side-steps that make progress in science, literature and the 
arts. 

To return : " If a person is kept clean, takes daily ex- 
ercise, inhales pure air, that such a person cannot develop 
tuberculosis if heredity is thrown out." If heredity be 
thrown out we take it for granted the subject is perfectly 
healthy so far as tuberculosis is concerned. The sentence 
then reads : If a healthy person be kept clean, takes daily 
exercise and breathes pure air he cannot develop tubercu- 
losis. 

Keep clearly before you the proposition. What is it to 
develop tuberculosis? "Answer ye who will." Tubercu- 
losis has been defined a constitutional disease, etc. If one 
develop tuberculosis he must develop or acquire a constitu- 
tional disease. How does one develop or acquire a consti- 
tutional disease? This one disease, tuberculosis, is devel- 
oped or acquired in one way — only one — suspension of at- 
mospheric influence. If there be no suspension of atmos- 
pheric influence there can be no tuberculosis. If the healthy 
person be kept clean, takes daily exercise, etc., there is no 
suspension. Therefore there can be no tuberculosis in his 
case. 

"But," says Dr. G., "I have seen cases that fulfilled 
all these requirements to a most perfect degree and yet did 



—230— 

develop tuberculosis," etc. The writer asks, " How can 
these things be?" Various explanations may be given. 
The one most probable is that Dr. G. is mistaken in his 
cases. 

In this connection perhaps another conversation will be 
allowed. Some time ago, on meeting my friend Dr. X. C. 
Scott, of Cleveland, O., he congratulated me on a paper read 
at a certain society. His language was somewhat as fol- 
lows : " Doctor, it is seldom I listen to papers outside my 
specialty, but yours was an exception — one of the best I 
ever heard. But, by the way, your theory of suspension 
don't work. Why, this very summer I traveled all through 
Mexico, and I saw many cases of tuberculosis. The climate 
is warm, the people live in the open air, and if you are right 
there ought not to be any disease of this kind. You are 
evidently mistaken." He continued : " Oh, by the way, 
doctor, do you know of a peculiar custom of sleeping in 
Mexico? They always wrap their head and face in a 
blanket." 

Is it clear why there is tuberculosis in Mexico? 

Suppose some one should tell you that Dr. Gordon, of 
Mexico, committed suicide by drowning. How can it be 
possible? There is but little water in Mexico. How much 
water does it take to drown when one is so disposed? So 
suspension of atmospheric influence may be produced by 
simply covering the month during sleep. 

It requires but little suspension to produce a diseased 
constitution. A diseased constitution so caused allows the 
tubercle bacilli to enter and grow — so-called tuberculosis. 

With due credit to Dr. Gardiner for his honesty, wis- 
dom and acuteness of perception, is it not probable he is 
mistaken? Have any of these patients — referred to as 
healthy — had stenosis of the air passages? If so, suspen- 
sion of atmospheric influence. Have they had measles or 
pertussis? If so, was recovery perfect? If not, suspension 
of atmospheric influence. Did any of these healthy patients 
ever work at an unhealthy vocation, as stone-cutting, etc. ? 
If so, suspension of atmospheric influence. Did any of these 



—231— 

parties, at any time, have a history of slow recovery from 
typhoid fever, with lung symptoms? If so, suspension of 
atmospheric influence. Tuberculosis frequently follows 
after the lapse of years. 

One other question : Who in any land can say in any 
case that heredity is excluded? Heredity, like the sun's 
influence, is felt in every land where a race exists. Let no 
one assert the contrary — / know this is true. Hereditary 
influence no man can measure. When one asserts heredity 
is left out he only approximately determines this truth — 
nothing more. Dear doctor, the writer feels assured you 
are mistaken. 

We close with an extract from a letter referring to 

State regulation of marriage. 

Fall River, Mass., August 24, 1898. 
H. H. Spiers, M. D., Ravenna, O. 

My Dear Doctor — I have just read your article in the 
Medical Record of August 20th, and wish to thank you for 
it. As to the question of State regulation of marriage I 
think you might have gone a step further than you did. The 
bill introduced into the Ohio Legislature was certainly a step 
in the right direction, and, as you say, in the years to come 
some measure of similar character will be enacted for the 
protection of the body politic. 

I am present at work along the same lines and may 
have something to send you one of these days. State regu- 
lation of marriage is as important and as much a function 
of the State as regulations covering vaccination, contagious 
diseases, boards of health and the like. 

Very truly yours, 

Geo. L. Richards. 



939L 



THE SOIL 

For many years, a few medical writers had observed 
the value of open air treatment in tuberculosis. 

Notably Austin Flint, Sr., mentions this in his " Practice 
of Medicine," 1873, in speaking of the early settlement of 
Illinois. Others could be referred to, but it is not the object 
of the writer to enter into historical research at this time. 
Suffice it to say, no writer — English or German — so far as 
known, ever laid down a law indicating a line of treatment 
for tuberculosis. The writer claims priority in this. 

True, Koch discovered the tubercle bacillus, and 
claimed it the cause of the disease. That Koch is a micro- 
scopist, none will gainsay. That he lacks in practical 
application is shown in his vaunted tuberculin. 

But it is evident to every one that no plant organism 
creates its own soil. The soil and organism are two separate 
entities. The organism cannot exist without the soil, and 
must of necessity be secondary. To say a vegetable organ- 
ism creates that in which it grows, is contrary to reason 
and common sense. The bacillus per se is as inert as the 
clods of the valley. In truth all authors now recognize 
a soil. In what this soil consists no one has definitely 
stated. 

The law of tuberculosis plainly indicates the character 
of the soil, and how formed. With this truth before us 
the treatment of the disease is rendered more clear and sim- 
ple. The law is as follows : The death rate from tuber- 
culosis is in direct ratio to suspension of atmospheric influ- 
ence, i. e., if the suspension be great, the death rate is great, 
and vice versa. Now as to treatment, if there be an entity 
creating the soil, remove the entity and the formation of 
soil ceases. If the soil allow the entrance or growth of 
the tubercle bacillus, when the soil is removed the bacillus 
disappears. This has been the teaching of the writer for 



—233— 

many years. Bacteriology may dispute this ground. It is 
its province to do so. But nothing is made by the germ 
theorist in claiming that which he cannot maintain. 

Bacteriology, like all kindred studies, must rest on 
merit or worth alone. Xo other basis will be accepted. It 
remains for the thinking man to put at its par or face 
value all these things. They are worth just the worth that 
can be shown of them ; no more nor less. Examine and 
pass on them for yourself. This is the province of every 
physician. The writer well knows in making these state- 
ments he is at variance with certain medical men. The 
truth will ultimately prevail. One with truth is a majority; 
majorities we seek. To the writer it is sometimes puzzling, 
and at other times amusing to hear remarks on soil. Speak 
to the average physician of soil in tuberculosis, and you will 
hear remarks like these : " There is nothing new in this," 
' Tell us something new," " All doctors speak of soil," " We 
are taught of soil in the schools." 

Doctor, please tell us in what the soil consists ? 
' The soil is a dyscrasia," " A depression of system," 
" A lowered vitality," " A malnutrition," " Anything that 
lowers the vital powers," etc. 

Let us see if these definitions be accurate. Do any one 
of these answers tell us plainly in what the soil consists? 
Does dyscrasia, lowered vitality, depression of system, mal- 
nutrition, etc., make it plain in what a soil for tuberculosis 
is, or is not ? We think not. 

Hundreds of people have dyscrasia, lowered vitality, 
depression, malnutrition, etc., who have not tuberculosis. 
If the soil consists in these, why do they not always have 
the disease ? But they do not. Seldom do they. Can you 
bleed one into tuberculosis? This is depression. Can you 
starve one into tuberculosis? This is lowered vitality. Do 
dyspeptics always have tuberculosis? Here is malnutrition. 
Will loss of sleep cause tuberculosis? In this the vital 
powers are lowered. 

It is seen that soil consists in more than these, or 
perhaps better, these do not cover the ground of soil in 



—234— 

tuberculosis. The disease does not invariably follow these 
conditions. In truth the disease seldom follows these con- 
ditions. There must be something else. What is this some- 
thing else? 

The law plainly indicates : Suspension of atmospheric 
influence. How do you know this to be true? "The proof 
of a pudding is in the eating." Because suspension of at- 
mospheric influence is always the first stage of the disease 
tuberculosis and then the bacillus enters secondarily. The 
suspension creates the soil. But why not say suspension 
of oxygen influence? The oxygen is the principal element 
of the atmosphere left out, is it not? True, it is an element 
left out, but not the only element. 

Inhalation of oxygen does not restore the patient to 
health, whereas the atmosphere does, i. e., in curable cases 
of the disease. This is shown in practical experience with 
tuberculosis, as many can testify. What the atmosphere 
contains of a vitalizing nature, aside from the oxygen, the 
physiologist has left unanswered, but that it contains more 
than this, the writer is ready to affirm. Hence in his law 
he uses suspension of atmospheric influence. The writer 
said he had been amused in the loose way in which soil 
is used. 

A short time ago a physician stated in substance, as 
follows : "I was offered a position as manager in a sani- 
tarium, but refused. Was afraid that in some way I would 
get the soil, and then you know there is no hope." Soil 
today has a scriptural garb, and tubercle bacilli are spoken 
of as seed. "Some fell by the wayside, some in stony 
ground, and some took root, etc." There is this difference : 
Our Savior told in what the soil consists ; not so the bacteri- 
ologist. Medical teaching at present is somewhat as fol- 
lows : An agent in mid air, — with ship gently sailing — 
is scattering bacilli right and left, and loudly calling "be- 
ware, beware, beware of getting the soil!" What soil? 
Should Uncle Sam place at each cross-road in his vast do- 
main, some startling announcement like this : "Beware of 
the guyascutas! It is found in every town and hamlet. 



—235— 



Its bite is certain death!" he would be the recipient of a 
ton of letters in a few hours, asking- a description of the 
animal. Such information would have to be coming forth- 
with. Not so in medicine. One can lecture for years on 
soil in tuberculosis, and not be asked to clearly define the 
term. Only a short time ago we were told an abraded 
mucous, or cutaneous surface let in the dread tubercle 
bacillus, and tuberculosis followed. Later, of a constant 
conflict at the portals of entrance — sometimes lasting for 
years — the patient meantime dying of another disease. To- 
day it is judicious care, not to secure a hypothetical soil. In 
others words, be afraid of an undefined entity. Tomorrow 
perhaps it will be something else. 

Now what the author wants, is a little more clearness 
in apprehension, or perhaps, definition. Suspension of at- 
mospheric influence is induced in what way ? The following 
was published many years ago, and explains clearly the 
views of the writer. Of course nothing of this kind can 
be fully satisfactory : 

Suspension of atmospheric influence. 

•£ f Impure J 111 ventilation, 

atmorphere ( vocation, etc. 



o 






o 

g 
"J3 



S 

o 
u 



Impoverished 
atmosphere 



bjo 



> tfi , 

u 

n 



Original 



Acquired 



( Over heating 
j rooms, 
] improper 
(^ventilation, etc. 

\ Heredity 

/ Disease, 

\ exposure, etc. 



We said " the proof of a pudding is in the eating." 
Test any of the above conditions, and see if the writer be not 
correct in his ideas of soil in tuberculosis. Go through the 
prisons, convents, workshops, etc., or examine the records 
of the same, as to sickness and death rate from tuberculosis, 
and secure results. Place animals under like conditions, 
and see if like results be not obtained. This certainly ought 
to satisfy as to suspension from without, in causing or ere- 



— 236— 

ating a soil. If there be these conditions in the home or 
shop, remove them and the soil disappears. This is the 
true secret in the prevention and treatment of tuberculosis. 
When suspension takes place from within, it is seen there is 
a different condition creating the soil. A different method 
must be taken to remove the same. 

What does one inherit in tuberculosis? A lung tissue 
that does not allow a perfect aeration of the blood. He in- 
herits a thickened and inelastic lung tissue, a lung tissue 
that requires greater effort on the part of the subject to 
secure aeration, or to remove suspension when present. 
Hence he is more subject to tuberculosis, and less likely to 
have it removed. 

Here is a physical infirmity that can be changed only 
through the generations by proper selection in marriage. 
Should the tuberculous marry is a subject for legislation. 
When there is an acquired or thickened lung tissue, as after 
measles or pertussis, there is great danger from suspension 
or the creation of soil. Records show a greater death rate 
from tuberculosis after these diseases than from others. 
The reason is obvious. The thickened lung tissue leads 
to the creation of soil. The soil, then, in whatever way 
created, is one and the same. The method of removal must 
be in accordance to the way created. It is also seen, the 
tubercle bacillus is secondary as a factor in the creation of 
the disease. This is certanly worth knowing, for in the 
prevention or cure of tuberculosis it may be so regarded. 

A celebrated writer said, "Care for the minutes, and 
the hours will care for themselves." The present writer 
says, "Care for the soil, and the bacilli will need no care." 



—237— 



TRUTHS CALMLY CONSIDERED. 



A report or synopsis of the transactions of the British 
Congress on Tuberculosis is before us, and we notice : 
"The factors of treatment other than diet receive little more 
than mere mention in the proceedings." Why the omis- 
sion? 

That drugs have value in the treatment of tuberculosis 
is known to every observing physician. That drug treat- 
ment per se is of little value is also clearly recognized. 
When to use drugs, the kind and dosage, must ever be left 
to the discriminating practitioner. Xo one can lay down 
fixed and infallible rules for guidance in the many phases 
of tuberculosis. That there are occasions when they should 
be used none can deny. 

One patient desires relief from the persistent hacking 
cough, another from the exhausting night-sweats, still an- 
other from a prostrating diarrhea or hemorrhage. Relief 
is asked and must be given. These and kindred conditions 
are met by appropriate treatment. 

But the wise practitioner does not confine himself to 
drugs alone. All accessories are used in treatment. One 
of these is diet or forced feeding. While duly considering 
the value of diet in tuberculosis, the wise physician will 
recognize it is not all in all. It is only an accessory. 

The life and well-being of the tuberculous does not 
depend on food alone. There are other factors worthy of 
consideration in this connection. We mention some of them. 

Two things are clearly recognized: (a) Tuberculosis 
is a disease of civilization; (b) the civilized are the best fed. 

Speaking, then, in toto, good feeding may be a cause 
of tuberculosis, but it is manifestly neither a preventive nor 
cure, else the civilized world would be free from the disease. 
There is no other alternative. In the treatment of tuber- 



—238— 

culosis something more than diet or forced feeding is 
required. 

The British Congress has a high object in thus coming- 
together — the stamping out of tuberculosis. The writer 
does not question the motive in the least. It is the method 
pursued. Let us illustrate. 

Should a society of ax-grinders meet to discuss the 
wage problem and then spend their time in talking of the 
weather, one could see the irrelevancy of the proceeding 
— perhaps not so clear when applied to the British Congress. 
But if the best-fed nations or bodies of people on the earth 
are most afflicted with the fatal disease tuberculosis, and 
this fact be accepted as patent to all, is it not irrelevant for 
any body of scientific medical men to publicly announce 
"diet" as the sine qua nonf Of the two bodies, would not 
the ax-grinder use his time to the wiser purpose ? We leave 
this to others more competent. 

What is tuberculosis? A constitutional disease depen- 
dent largely on the evils of civilization, and governed by the 
following law : The death-rate from tuberculosis is in direct 
ratio to suspension of atmospheric influence. 

Thousands are working in a dust-laden atmosphere — 
suspension. Thousands are living in ill-ventilated apart- 
ments — suspension. Thousand are suffering from the fac- 
tor of heredity in tuberculosis. Take it as you please, the 
writer claims one inherits a lung tissue that does not allow 
a perfect aeration of the blood — suspension. Thousands 
are suffering from thickened lung tissue, catarrhal condi- 
tions, etc. — suspension. 

Thousands are suffering from all these combined : 
Working in a dust-laden atmosphere by day, sleeping in 
an ill-ventilated apartment by night, the subject of heredity 
in that father or mother died while young of tuberculosis, 
also the subject of chronic cough. 

Suspension is the cause of tuberculosis in that it creates 
a soil for the natural entrance and growth of tubercle 
bacilli. Are bacilli of tuberculosis factors in the disease? 
Yes, in that they hasten disorganization of tissue or death of 
the patient ; not primary factors in that they do not create 



—239— 

the soil. The soil is induced by suspension, and the bacilli 
are then given a natural entrance and growth. 

The writer asks one plain question — only one : Will 
"diet" prevent suspension? If so, it is a means to cure in 
tuberculosis. But it is not the only means — only one of 
many. What other means have we at hand? 

Recognizing the soil as the primary factor, and the law 
regulating its induction, we have a means at hand at once 
potent and conclusive. What are these means? Efforts 
made in every direction to remove suspension. If dust, ill- 
ventilation, heredity, catarrhal conditions, etc., remove the 
conditions, etc., by education and legal enactment. 

"But," says the germ theorist, "how about the bacillus ? 
What are we to do with the bacillus ?" 

Leave the bacillus alone ; he needs no care. Care for 
the conditions which prepare the soil, and the writer pledges 
his ideal reputation the bacillus will cause no trouble. It is 
perfectly harmless. 

To him, who, by a broad experience, comprehensive 
grasp and clear vision of natural relations, it is seen that 
present conditions do not meet requirements. Diet, care of 
the bacillus, tuberculin, etc., do not prevent tuberculosis ; 
neither do they cure. 

Mankind are looking for cure and prevention of the 
disease. In this search please remember the old adage, "An 
ounce of prevention is worth a pound of cure." Prevention 
must always hold the greater field, the surer place. A per- 
fect cure will never be found except in prevention. This 
truth ever bear in mind. 

But in the present state of our science what factors 
are most conducive to cure in tuberculosis? We answer 
boldly, without fear of controversy, the open-air treatment 
of the disease. 

Another question: Why does the open-air treatment 
of tuberculosis take precedence to all other methods? In 
that it fulfills all indications most fully. 

What are the indications? The one great indication 
is the removal of soil or that which leads to it — suspension. 



—240— 

What is the rationale of this procedure? It is simply 
this : The law of tuberculosis says the death-rate is in direct 
ratio to suspension. 

If true, should we by any method lessen the suspension 
we lessen the death-rate in the same ratio? Is this clear? 
If so, is it of value? The writer thinks it is. 

If dust, ill-ventillation, heredity, catarrhal conditions, 
etc., are a means of suspension ; if we lessen these, we lessen 
the death-rate or increase the proportion of cures. 

Does observation and a clear examination of facts jus- 
tify one in making these statements? The writer believes 
it does. 

In 1893 the law of tuberculosis was presented to the 
Ohio State Medical Society at Put-in-Bay. It is published 
in the Transactions of the same year. Two years before this 
date the law was read before the Portage County Medical 
Society. Since the above dates three editions of "Tuber- 
culosis or Consumption," containing this law, have been 
sold in the United States. The fourth enlarged edition is 
now on the market. 

When we consider the little open-air treatment in vogue 
prior to the above dates, when we consider the extent to 
which it is being used at present and the relative great 
proportion of cures, one can but fairly estimate its beneficial 
results and assured continuance. The writer feels proud 
in commending this treatment to the profession at large. 

Some may ask, while it is plainly seen the open-air 
treatment leads to a more perfect aeration of the blood or 
removal of suspension, can it be shown that the growth of 
bacilli is affected thereby? The writer thinks it can. Sus- 
pension leads to the creation of a soil. The tubercle bacilli 
then enter and grow. A perfect aeration removes the soil 
and the tubercle bacilli are compelled to leave. 

In other words, the writer divides tuberculosis into 
three stages, simply for convenience : 

First stage — Creation of soil. 

Second stage — Natural entrance and growth of the 
so-called germ, tubercle bacillus. 



—241 

Ihird stage — Disorganization of tissue, or death of 
patient. 

It is seen the bacillus is not a factor in the first stage 
of the disease. It is a factor in the second stage. What 
does it accomplish? Hastens the third stage — disorganiza- 
tion of tissue or death of patient. 

Now no one could claim it would be wise to inject a 
faulty tuberculin in the first stage of tuberculosis. Why? 
It would hasten the very disease he wishes to prevent or 
cure. 

No one could claim tuberculin a diagnostic in the first 
stage of the disease. Why? No bacilli are growing. 

No one could claim that any alkaloid of tubercle bacilli 
could create, prevent or remove the first stage of tubercu- 
losis according to the writer's classification. 

It is thus shown tubercle bacilli have no causative rela- 
tion or association with the first stage of tuberculosis. It 
is purely a case of suspension, or imperfect aeration. A 
perfect aeration in the patient would remove this stage in 
every case. It would be a perfect cure. 

In the second stage there is the soil plus the growing 
tubercle bacillus. The writer claims if the patient has 
enough healthy lung tissue to induce a fairly perfect aera- 
tion, and if he persists in getting the aeration, the aeration 
will remove the soil and compel the bacillus to leave. There 
is no longer a food for the plant growth. 

This truth is worthy Of consideration, and is being 
demonstrated every day in published records. Yet we 
have writers who are continually harping on systematic 
immunity, as if this were a thing to be had on asking. 
The writer thinks a systemic avoidance would be more 
proper. In most cases this may be had. 

In the third stage of the disease there is disorganization 
or destruction of tissue. The lung may be broken down or 
gone. No power on earth can restore a destroyed tissue. 
The age of miracles is past. A knave or fool may promise, 
but these promises are never fulfilled. While we say this, 
at the same time life may be prolonged by a judicious aera- 



—242— 

tion of the lung that yet remains by an outdoor life. 

The question may now be asked, what method or meth- 
ods of aeration are best adapted to the individual patient, 
and in what locality? These questions, to be properly an- 
swered, would require a large open book to which we have 
not access or time to procure at the present writing. 



—243— 



SANITATION. 



The word sanitation is used in the sense of erecting 
and equipping buildings for the segregation and care of 
the tuberculous, whether by private or public funds it mat- 
ters little, the object being to care for or cure the patients. 

Perhaps, to avoid misunderstanding, it would be well 
to define tuberculosis at the outstart. Tuberculosis is a 
constitutional disease, dependent largely on the evils of 
civilization and governed by the following law : The death 
rate from tuberculosis is in direct ratio to suspension of 
atmospheric influence. 

It will be seen that the disease is spoken of as a consti- 
tutional one. Whether is be tuberculosis of the joints, 
mesentery, meninges or lungs, it is constitutional from 
its incipiency. 

It will also be seen that the germ tubercle bacillus is not 
mentioned as a causal factor. That it is a factor in the dis- 
ease we think no one can deny. The writer is emphatic in 
denying its causal action, hence the law : The death-rate 
is in direct ratio to suspension of atmospheric influence. 

Our interpretation of this law is as follows : Suspension 
of atmospheric influence or imperfect aeration of the blood 
creates in the individual a soil or condition of tissue that 
allows a natural entrance or growth of the plant tubercle 
bacillus. The first stage of the disease, then, is the creation 
of the soil. The plant organism or germ tubercle bacillus 
then enters and commences to grow, or take root, in this 
prepared soil. The entrance or growth of this plant or germ 
is the second stage of tuberculosis. This growth is now 
a factor in the disease. What does it do? Hastens the 
third stage — breaking down of tissue or death of patient. 

Our classification is a natural one, and is as follows : 

First stage : Creation of soil. 

Second stage : Entrance or growth of tubercle bacillus. 



—244— 

Third stage : Breaking down of tissue or death of pa- 
tient. 

Question : Can tuberculosis exist in the absence of the 
bacillus ? 

Answer : It certainly can. 

How, then, do you diagnose tuberculosis ? 

We will speak of this later on. Perhaps a few remarks 
in another connection may not be out of place at this time. 
When this law, indicating a line of treatment, was given 
to the profession, there was not a sanitarium for the outdoor, 
physical culture method of treatment in the United States. 
Today nearly every State in the Union is dotted with them. 

The writer has devoted some time and attention to 
these subjects, and he asks a little forbearance and consider- 
ation from the profession. While his dictum is not exactly 
the "Law and Gospel" in this matter, it certainly points in 
the right direction. Should anyone doubt this, he is referred 
to published reports of cures obtained now as compared 
with cures fifteen years ago. This will certainly convince 
the honest doubter. 

We stated the object of sanitation is to segregate and 
care for or cure the tuberculous. Two things are patent 
to the observing: 

1. The want of confidence, on the part of the physi- 
cian, in his ability to treat or cure tuberculosis. 

2. The ignorance or false education, on the part of 
the patient, regarding his ailment. 

It is the common opinion of the medical profession 
that no tuberculosis is cured. It is the common education 
of the laity that all consumptives die of the disease. The 
physician and laity alike need instruction. If the physician 
have no confidence in his own ability, he can inspire no con- 
fidence or hope in the heart of his patient. If the patient 
be told the nature of the ailment he at once loses all courage 
and gives up treatment in despair of cure. It is seen there 
is a fault on both sides, and it works one way. Treatment 
is given up. The patient goes steadily to the grave, as 
everyone expected, and the doctor is not blamed. The time 



—245— 

is coming when blame will be attached to ill-advised treat- 
ment and death, but that time is not yet. 

As the writer takes it, sanitation would be beneficial in 
that it would place in charge of each building or location 
some competent medical man who has not only confidence 
in his ability to cure, but one who could inspire this confi- 
dence or hope in the minds of the patients by results in 
treatment. The rule would then work both ways, to the 
betterment of all. concerned. This would certainly be a 
happy consummation — as Shakespeare would put it, "A 
consummation devoutly to be wished." 

Having met personally over one-half the medical pro- 
fession of Ohio in the sale of my third edition of "Tuber- 
culosis or Consumption," the writer is in position to speak 
as to the consensus of medical opinion on treatment. These 
are common expressions of those who trust in drugs alone : 
"Nothing so disheartening," "My patients all die," "No 

results from treatment," "D the bacillus !" "Tuberculin 

is a fraud," "Have no confidence in anything," "Am afraid 
of the disease," "Will not treat it," "Turn over all my 
patients to others." Three physicians declared drugs would 
cure the disease, and named the drugs in confidence. Found 
on questioning they were using open-air and exercise in 
connection with the drugs (?). Listen to this: "Everyone 
who has tried the open air and exercise has met with 
benefits explained in no other way." Says one, "Don't 
the open air kill the tubercle bacillus?" Are we not 
told the tubercle bacillus is ubiquitous? Is not the world 
full of air? Why is there a living bacillus ? In other words, 
why don't they all die? 

Much as we all appreciate the worth of open air, it 
has not yet exterminated the bacillus. Can anyone say that 
it ever will? But, says one of our most talented Ohio men, 
"if open air be beneficial and cures tuberculosis, please give 
us the modus operandi." 

We stated that imperfect aeration of the blood creates 
a soil or condition of tissue that allows the natural entrance 
or growth of the tubercle bacillus. Reverse the proceeding. 



—246— 

In other words, give the patient a perfect aeration and the 
soil is gradually remover, i. e., the perfect aeration removes 
the soil. Is the writer clear? 

Let me illustrate: A train of cars is moving on a 
straight track at twenty miles an hour. Danger ahead! 
The engineer reverses the engine. What is the result ? The 
train soon comes to a stop and then moves in an opposite 
direction. The physician who gives this perfect aeration to 
his patient and cures him is the engineer who reverses his 
engine and escapes danger. Is not his action 'to be com- 
mended and followed? It certainly is. 

Have we made our position plain? Every case of tu- 
berculosis in the first stage can be cured. Yes, but as yet 
there are no bacilli growing. How about cure when the 
bacilli have taken root, or in the second stage of the disease ? 
Can one cure then? Listen to the author's reasoning: If 
imperfect aeration creates a soil, a perfect aeration would 
remove the soil. If the soil so created allow entrance or 
growth to the tubercle bacillus, when the soil is taken away, 
what becomes of the growing bacillus? It, likewise, dis- 
appears. It dies. It all hinges on getting the perfect aera- 
tion. In other words, if there be enough healthy lung tissue 
to induce a fairly perfect aeration, if the patient persist in 
getting this aeration, the bacilli disappear and the patient 
is cured. 

All cases of tuberculosis, in the second stage, can be 
cured unless heredity be a factor. What do you mean by 
heredity ? What does one inherit ? He inherts a lung tissue 
that does not allow a perfect aeration of the blood. He 
inherits a thickened lung tissue and one not so elastic as the 
normal. One with this tissue must breathe more deeply or 
more frequently to get the same aeration as in health. For 
this reason a soil for the bacillus, in these patients, is culti- 
vated more easily, and when secured is more difficult to 
remove. This is the main reason why heredity may be a 
strong factor in tuberculosis. Bacteriology is silent on this. 
How can this peculiar lung tissue be changed or bettered? 
In the generations to come, by the enactment of a marriage law. 



—247— 

In heredity, sanitary science can accomplish but little. 
The reason is obvious. Education must precede and create 
public sentiment. Without this, legal enactment would 
be valueless. This is seen in all temperance legislation. 
Without an education or public sentiment to enforce 
this legislation, it is worse than useless. A law 
that can not be enforced is in truth no law at all. Today, 
the marriage question is one that suffers or tolerates no in- 
terference. The present state of public sentiment is against 
change. Education must take precedence. But just think 
of it ! Every one of proper age can get a license, and what 
minister refuses to marry? Nearly all are allowed to 
-marry, and the State endorses it. It is public policy, it is 
thought. The human race will deteriorate from this cause 
until some change be made. Who dare advise a change? 

In the third stage of tuberculosis treatment is less satis- 
factory or more difficult. Here there is destruction or dis- 
organization of tissue. One thing every physician should 
know, or at least he will ultimately find out : Lung tissue, 
disorganized or destroyed, can never be restored. It is gone 
forever. He who says he can restore is either a knave or 
a fool. All that can be done is to bring into requisition 
the healthy lung tissue that yet remains. Yet it is astonish- 
ing, in some of these cases, the amount of good that can 
be accomplished by simply comprehending the situation and 
acting accordingly. By feeding, out-door exercise, deep 
breathing, judicious use of drugs, etc., cases may sometimes 
be snatched from the tomb, or life prolonged in others. This 
is the most that can be done. 

In all stages of the disease sanitation would be benefi- 
cial in that it would compel obeyance of orders as to diet, 
exercise, out-door life, etc. These are great factors in treat- 
ment and cure. They must be strictly adhered to, to receive 
permanent benefit. To the neglect of them in private prac- 
tice may be ascribed the manv failures in treatment. This 
brings us to another phase of the question, which must be 
taken up at a future time. 

We stated that the engineer, who sees the danger and 



—248— 

reverses his engine is the physician who recognizes the 
disease in its early stage and gives his patient relief and cure 
by a more perfect aeration — a very simple procedure, but 
one which many of our medical men are not yet conscious 
of. Suppose, instead of reversing the engine, the engineer 
entertain a peculiar theory and works on this. Imagine 
his theory, when a bridge is washed away, be as follows : A 
train of cars may be made to leap a chasm and strike the 
track on the opposite side by an increase of speed. At the 
first opportunity he puts his theory to test. Instead of 
reversing the engine, he pulls the throttle. The train leaps 
into the chasm, but the engineer never makes the experiment 
again. The reason is obvious. All on board go to untimely 
graves. It is an impractical or theoretical experiment. 

This is but one of the many failures in medicine. His- 
tory is full of them ; one will suffice. 

A few years ago a savant announced the tubercle bacil- 
lus the primary cause of tuberculosis — the injection of its 
alkaloid the cure for the disease. The theory is put to a 
practical test and thousands are hurried to untimely graves. 

It will be seen that the analogy is complete, except as 
to the death of the engineer. The untrained yet believe in 
the experiment. 

Were is more dangerous for the one having the experi- 
ment in charge, this foolishness would cease. 

Why is this treatment fraught with so ill a result ? The 
reason is clear. Many patients are crowded into imperfectly 
ventilated rooms, and the real cause of the disease given 
full sway. In this condition, should an impure tuberculin 
be injected it would further hasten the very disease it is 
sought to cure. Two dangers are seen : 

1. Ill ventilation — the primary cause of tuberculosis. 

2. Impure injection, or, hastening of second stage. 
Let us look a little further. Many have recognized the 

German scientists as authority on microscopy, which they 
are, yet think their system of treatment needs a little bols- 
tering, which it does. Notice the following: Sanitaria are 



—249— 

started with the avowed purpose of using tuberculin, and 
reports of said injection are made from time to time with 
results as to per cent, of cures. At the same time open-air 
treatment is given to the patients of said sanitaria, and no 
credit given for the same. In other words, it is a mixed 
treatment of open air and tuberculin, but tuberculin is given 
all the credit. The writer thinks this manifestly unfair. 
The open-air and tuberculin treatment should each stand 
side by side as to their comparative merit. Not that we 
deny the right to use both tuberculin and open air in con- 
junction, as accessories each to the other, but that each so 
used should be given its due credit in reports. Nothing- 
more. 

It is then found that tuberculin is nil, as many observ- 
ers have stated, while the open air is the best that medicine 
suggests. It is best, in that it fulfills every condition and 
meets every requirement. It is truly the engineer's honest 
effort to reverse his engine on the straight track and cause 
the train to move in an opposite direction. 

That these ideas are clear may be seen by a comparison 
of the open-air treatment on the one hand and the mixed 
treatment on the other. Tuberculin will then be shown as 
valueless. The writer so regards it. 

Nor is this all. Tuberculin stands not alone in causing 
this widespread deception. The inhalation method is also 
guilty. There is this difference : The various methods of 
inhalation have value per se, but the value is not seen by 
the attendant in its true light. In illustration, the consen- 
sus of medical opinion on the action of tuberculin alone in 
treatment is nil. The same consensus on inhalation alone is 
that it has value. Why is the one of less value than the 
other in the estimation of the profession ? Simply because 
the one does not fulfill the indications in the case, while the 
other does. "The proof of the pudding is in the eating." 

As we have before intimated, in order to study tuber- 
culosis in all its phases, and clearly discriminate as to com- 
parative value of remedies, we must first clearly apprehend 



OK 



50— 

the nature of the disease. So long as we regard it dis- 
tinctly germicidal, so long will we be misled in treatment- 
Nothing is more clear. 

What is tuberculosis? A constitutional disease de- 
pendent largely on the evils of civilization, and governed by 
the following law: The death-rate from tuberculosis is in 
direct ratio to suspension of atmospheric influence. Sus- 
pension of atmospheric influence, it is seen, is the cause of 
the disease. 

Having recognized the cause, we can more clearly 
suggest or devise a cure or preventive. No uncertainty in 
this. For instance, cold weather is at hand. More food> 
fuel and clothing are required. These must be had, or one 
must suffer. It is useless to speculate and say cold and 
hunger are relative terms, and exist only in one's imagina- 
tion. Even a Dr. Eddy would appreciate a square meal or a 
good fire on a cold day. Want and suffering are cognizant 
entities. No mistake. So in tuberculosis. Impure or im- 
poverished air must be rendered pure or wholesome. Im- 
perfect or incomplete aeration must be rendered perfect or 
complete. Nature will not long tolerate a vacuum or poison 
in one's lungs or stomach. It is well that nature cries out 
for redress. Redress must be had. In tuberculosis this is 
truly the province of the physician. 

The question now is : In what way can this redress 
best be granted? Is it best to imagine the disease does not 
exist? This is Dr. Eddy's method. Will the declaration 
that one-seventh of the death-rate is due to tuberculosis rid 
us of the disease? If so, it ought speedily to disappear. 
The writer thinks something more efficacious than these 
must be brought forward. 

The inhalation method is a step in the right direction. 
What does inhalation accomplish? Of itself, but very 
little ; as an aid to deep breathing — lung expansion, or a 
more perfect aeration — a great deal. Herein lies the true 
value of all methods of inhalation, viz., chest expansion or 
the calling into use of latent air cells hi the lung. Herein 
the fallacy, viz., that medicaments have value per se. 



—251— 

We stated that inhalation per se has little value. Let 
us endeavor to make plain our ideas in this connection. A 
sanitarium is started with the avowed purpose of curing 
tuberculosis by this method — inhalation. It is assumed first 
that the medicament, whatever it may be, applied to the dis- 
eased organ, will effect a cure. This, to the writer, seems 
an unreasonable assumption. Tuberculosis, as already 
stated, is a constitutional disease. Have we any therapeutic 
agent, a topical application of which will cure a constitu- 
tional trouble? Should a cure be so effected would not 
one of necessity consider it as a mistaken diagnosis — as 
local rather than a constitutional one? 

In the second place, it is assumed that the remedy in- 
haled reaches the diseased tissue. This second assumption 
is as unreasonable as the first when we consider the residual 
air always present in the lungs. How can a spray or 
atomized solution pass through this residual air and reach 
diseased tissue? One can see how it could reach the throat, 
fauces, nasal passages, etc., but how reach the remote air 
cells ? 

Again, the diseased tissue is not always or entirely on 
the inner surface of the air cell. On the contrary, most 
of the diseased tissue is elsewhere. 

How is a cure effected? This is generally seen. The 
patient improves. The improvement is accredited to the 
medicament or apparatus used — a natural sequence. Is this 
a true solution ? That it is not the writer asks the following 
test: Place two patients, similarly affected, in adjoining 
rooms. On the one use the medicament and apparatus re- 
quired, on the other pure air inhaled by a simple method. 
Be equally persistent in each case and compare the result 
at the end of any stated period. It will be found the im- 
provement, in the main, is equally marked. Why the 
improvement? If the appliance or medicament caused the 
improvement in the one case, what caused the improvement 
in the other? The truth is, in either case it is caused by a 
more perfect aeration of the blood. In other words, the 
more perfect aeration removes the soil and the bacilli dis- 



—252— 

appear. The cure hinges upon the removal of the soil — 
a natural explanation. 

As stated, the creation of the soil for the so-called 
germ is a violation of law. The observance of law, in 
proper inspiration and breathing, removes both soil and 
germ, and demonstrates, we trust, for all time, the utter 
nonsense of the germ causing the disease. Of this we hope 
to speak later. 

In conclusion, sanitaria based on the idea that tuber- 
culin or inhalation of drugs cures tuberculosis, in the judg- 
ment of the writer, is built on a unstable foundation. The 
structure cannot stand. 

Truly, no portion of Scripture has been more clearly 
fulfilled in our age and generation than that pertaining to 
the crooked being made straight and the mountains brought 
low. Modern engineering has accomplished many remark- 
able feats. In no sphere is this more distinctly shown than 
in railroad engineering. Mountains are tunneled, chasms 
bridged or filled, curves or grades obviated, and the whole 
plan of the modern engineer is laid before us as a fairy tale 
or " Midsummer Night's Dream." These dreams of the 
intellect have been realized by clear, effective thought and 
action, thereby enhancing modern wealth and pleasure. 

While we do not live so many years to see and enjoy 
as did our reputed antediluvians, yet we witness more in 
our brief span. Age alone does not mark the length of one's 
existence — rather deeds witnessed or accomplished. Many 
living men are very old, not in years, but in experience' 
which is more valuable. 

Medicine has witnessed its many rapid evolutions. The 
causes of disease today are not the causes found as yes 
terday. We witness many, many changes, yet the tide of 
life moves on. We see more, know more, expect more of 
today. May our expectations be fully realized ! 

Experience in railroading has shown the cost of trans- 
portation is lessened by removing the grade or curve. We 
are told " Experience is a dear school-master," and " Fools 
will learn of no other," yet it must be acknowledged it is 



—253— 

the truly wise zvho profit from experience. 

Medicine has many grades and curves. They cost -us 
valuable lives. Let us endeavor to level and straighten. 
A valid reason is assigned for this. 

Illustration : The engineer sees danger ahead. His 
train is on a grade or curve. How best proceed to stop? 
Reversal will not answer. On the curve it means derail- 
ment or death to all. The air-brake on the grade, if up, 
will stop the train ; if down, if often will not. It is a time 
for lightning thought and rapid execution. The engineer 
acts quickest, wisest. 

So in medicine. We meet our grades and curves. In 
dread tuberculosis they are most plentiful. Let us attempt 
removal. Experience should make us wise. 

In treatment how best proceed in the third stage ? Ask 
the engineer how best proceed in the conditions named. 
He will answer, " Little can be done." Give us the treat- 
ment in the later stage and we will amply pay. Listen 
to the engineer : " Better, far better, to remove the curve." 
The Horse-shoe Bend in the White Plague is causation 
curve. Better, far better to remove the curve. What? 
Throw aside the idol of our toils, the dread bacillus ? Money 
squandered, labor wasted, time misspent — All are gone and 
what avails? 

Let us examine. Ask "medical science today for an 
accurate definition of tuberculosis, and it is somewhat as 
follows : Tuberculosis is an infectious disease caused by 
the tubercle bacillus, a ubiquitous vegetable organism which 
takes root in a suitable soil; the suitable soil in man is a 
depression of system, a lowered vitality, a dyscrasia, etc. 

The attention is called to three things at this time : 

1. The tubercle bacillus causes the disease tubercu- 
losis. 

2. The tubercle bacillus is everywhere present, and 
must have a suitable soil. 

3. The soil for the tubercle bacillus is an indetermi- 
nate factor. 

To any thinking man it will be seen at once that tuber- 



—254— 

culosis is not clearly understood. This misapprehension, 
for the want of a better name, we designate causation 
curve. This curve is costing thousands of valuable lives. 
As an engineer on the road we call for its removal. In 
other words, we ask that the track be straightened. Is our 
humble petition worthy consideration? 

What is tuberculosis? A constitutional disease, de- 
pendent largely on the evils of civilization, and governed 
by the following law : The death-rate from tuberculosis is 
in direct ratio to suspension of atmospheric influence. 

Theories in their place are well enough. Theories and 
practical ideas are oftentimes diverse. Practical ideas are 
what we want in so dread a disease as tuberculosis. What 
will relieve suffering humanity is the question above all 
others that should be considered. 

Have you a remedy for the disease? is asked every day. 
This remedy for tuberculosis has been chased for many gen- 
erations, and, like the will-o'-the-wisp, with similar results. 
" An ounce of prevention is worth a pound of cure." The 
prevention of tuberculosis is a removal of the curve. It is 
found, in the main, in a more perfect aeration of the blood. 

For many years we have entertained a beautiful theory 
regarding the motion of the earth. We now attempt to give 
it a proper airing in print. Remember, it is only a theory. 
As one looks into the heavens and considers the many 
planets revolving around central suns, he is led to ask why 
these bodies revolve and what power keeps them in place. 
Certainly some rational explanation should be given. We 
see nothing revolve on the earth's surface unless there be 
a power behind producing the motion. What reason can be 
assigned there is not a power or motive force at work on 
these planets? 

On studying the subject more carefully one finds the 
motion of the planets irregular. He also observes all crank 
motion is irregular. The following syllogism is then 
framed : All crank motion is irregular. The earth's mo- 
tion is irregular. Therefore, the earth is turned by a crank. 

In order to make the figure more complete, the earth 



—255— 

has an axletree, which rests on gudgeons or bearings at the 
poles, and is turned by means of a crank. 

Now if the earth be turned by a crank, some one must 
turn it, for it is evident cranks do not turn of themselves. 
Who turns the crank, however, is of minor importance, 
the important factor being, does the crank turn the earth? 
This is clearly demonstrated. 

ISIow let us account for the irregular motion. This is 
clear. While John Chinaman stops to pour on more oil, 
the earth's motion is retarded. Or while Laplander Joe 
stops to spit on his hands there is a little variation in the 
motion — an uncertainty. This variation becomes greater 
when he is whetting an appetite for breakfast and returns 
after partaking of several pounds of blubber. 

But, says one, " On what do these gudgeons rest? " In 
all probability on runners. It is known that at both poles 
there is an abundance of ice and snow at all seasons of the 
year. This affords excellent sleighing. 

Says another, " What causes the so-called tipping of 
the earth?" This is due to the axletree being more worn 
on one side than the other. In other words, the axletree 
i^as not properly tempered. 

Now, having accounted for the deviations in the earth's 
orbit more satisfactorily than heretofore, we trust the ex- 
planation will be accepted in the spirit it is given. Xo 
serums. Even should the theory be rejected in toto, we feel 
assured it cannot be successfully controverted, for no one 
has been there to see. 

If accepted, as no doubt it will be, we wish at this time 
to make a few observations. That there is, or ever has 
been, an open polar sea seems to us mere speculation. A 
ship could not pass through this so-called sea more than 
an air-ship could pass to the moon. An ice-ship could 
pass provided there were dogs enough to draw it. How to 
feed a sufficient number of dogs is a question. This seems 
a clear inference from the above theory. 

1. There is a zvell-beaten track around each pole of 
the ear tli. 



—256— 

2. The arctic explorer could utilize this track in north- 
ern trips. 

So soon as this road is reached they, the explorers, 
should follow it for a time and then start direct for the 
pole at the most auspicious moment. 

Presumably, as there are no fog-horns or signal sta- 
tions on this road, a word of caution is necessary : It would 
be well to keep a strict lookout for the car or sled. It might 
run down the dogs. A loss of dogs in a polar expedition is 
a sad calamity. On reflection we think that it would be 
best to dispense with dogs entirely. 

By establishing posts or feeding stations near this well- 
beaten track one could wait until the car passed and then 
hang on behind. Many medical men like to travel in this 
way. Some while thus traveling reason in circles. Others 
travel mentally in a loop and go in and come out at the 
same hole. But this is digression. "Let us return to our 
mutton." 

It is said the inventor, Edison, keeps the idea of practi- 
cal worth constantly in mind in all his experiments. The- 
ories may be beautiful, captivating to the imagination, but 
what is their practical north is the main question to be 
considered. Whether the tubercule bacillus, or soil for the 
same, be regarded the primary cause of tuberculosis, on this 
all agree. 

1. The soil precedes the growth of the bacillus. 

2. The open-air treatment best meets the expectations 
of civilized man. 

The third is presented for calm consideration : 

3. The rationale of open-air treatment is found in the 
following law: The death-rate from tuberculosis is in direct 
ratio to suspension of atmospheric influence. 



—257— 
INDEX. 

PAGE, 

Artificial Immunity 63 

Abeyance of Atmospheric Influence 104 

Annotations 112 

An American Need 182 

As Others See Us 223 

Bicycle a Preventive 69 

Cause of Tuberculosis 54 

Control 80 

Catechism 124 

Duties of the Hour 118 

Deep Breathing vs. Tuberculosis 176 

Dawning 186 

Education 42 

Food Product 46 

Germ Theory 59 

Heredity 26 

Introspection 217 

Incipient Tuberculosis 221 

Law in Tuberculosis 15 

Legislation 71 

Medical Theories 11 

Marriage 19 

Medicine 171 

Mathematics in Medicine 192 

Necessity of a More Perfect Aeration 202 

Outlook 159 

Preliminary Statement 9 

Precedent State 32 

Sanitation 243 

Status of the Bacillus 89 

The Soil 232 

Theory of the Production of Tuberculosis 210 

Truths Calmly Considered 237 

Vagaries 166 

Whom to Marry 38 



